Journal of National Institute of Neurosciences Bangladesh最新文献

{"title":"CT-Scan Evaluation for the Detection of Benign Parapharyngeal Mass","authors":"Md Abdul Alim, Rokshana Ahmed, Z. Haque, R. Islam, Rownak Jahan Jowarder, M. Rahman, N. Nahar","doi":"10.3329/jninb.v7i2.58098","DOIUrl":"https://doi.org/10.3329/jninb.v7i2.58098","url":null,"abstract":"Background: Detection of benign parapharyngeal mass is very crucial for the management of the patients. \u0000Objective: The purpose of the present study was to evaluate the CT scan for the detection of benign parapharyngeal mass. \u0000Methodology: This cross-sectional study was carried out in the Department of Radiology and Imaging at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from July 2009 to April 2011 for a period of around two years. All the clinically suspected cases of parapharyngeal space mass lesions attended in the Otolaryngology and Radiology & Imaging department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka were enrolled in this study. The patient in this study was evaluated according to the management plan for surgery followed in Otolaryngology department. The histopathology was performed by the histopathologist of the Department of Pathology at BSMMU, Dhaka, Bangladesh. All patients were undergone CT examination of neck and the comparison of the findings was done with the histopathology results. \u0000Result: A total number of 50 patients were recruited for this study after fulfilling the inclusion and exclusion criteria. Mean (±SD) age of the patients was 37.76 (±14.82). Sensitivity of CT to diagnose benign parapharyngeal mass was 92.1%, specificity 83.3%, positive predictive value 94.6%, negative predictive value 76.9% and accuracy 90.0%. The area under the curve value was calculated and was found 0.142 (95% CI 0.000 to 0.286) (p=0.000). \u0000Conclusion: In conclusion the sensitivity and specificity of CT scan for the detection of benign parapharyngeal mass lesion is very high. \u0000Journal of National Institute of Neurosciences Bangladesh, July 2021, Vol. 7, No. 2, pp. 118-121 ","PeriodicalId":16732,"journal":{"name":"Journal of National Institute of Neurosciences Bangladesh","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86150245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Loss of Consciousness at Onset of Subarachnoid Hemorrhage as Marker of Short Term Outcome","authors":"Rahat Amin Chowdhury, H. Rahman, A. Hasan, Iftikher Alam, M. Habib","doi":"10.3329/jninb.v7i1.54746","DOIUrl":"https://doi.org/10.3329/jninb.v7i1.54746","url":null,"abstract":"Background: Studies assessing the impact of loss of consciousness (LOC) on prognosis of subarachnoid hemorrhage (SAH) has been limited. \u0000Objective: This scientific assessment was done to determine the effect of LOC on outcome of SAH. \u0000Methodology: This hospital based observational study was done in Department of Neurology of Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2018 to December 2018. Patients with the diagnosis of SAH admitted in the in-patient wards of Neurology, Neurosurgery and Internal Medicine were taken as study population. The patients were divided in two groups with either presence (B) or absence of loss of consciousness (A). Group B was further subdivided into 3 subgroup depending admission WFNS scale grades (BI= WFNS II &III, BII=WFNS IV and BIII=WFNS V). Follow up was done in the stroke clinic, outpatient department of Neurology or by telephone interviews of patients, caregivers or family members. Outcome was measured by modified Rankin Scale (mRS). \u0000Result: A total of 75 patients were divided into group A and Group B. Six (8.0%) patients died during hospital stay, 6 died after 3 months. All those died during hospital stay were from group B. At 3 months, 16(21.3%) patients were lost during follow up. In group A at discharge 28.6% patients had poor outcome whereas 36% of patients in group B had poor outcome. Within group B most of the patients having poor outcome were in subgroup BIII (75.0%) compared to 33.0% cases in BI (p=0.023). About 16.7% cases in group A had poor outcome at 3 months and 75.0% cases in Group BIII. Furthermore, 8.3% patients died in Group A, however, 25.0% died in Group BIII. WFNS grade (IV or V) had statistically significant influence on poor outcome among patients having LOC (adjusted Odds ratio is 2.20, p=0.04 and 95% CI 1.03–4.71). \u0000Conclusion: Loss of consciousness at onset of SAH is an important marker for p oor outcome. \u0000Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 20-24","PeriodicalId":16732,"journal":{"name":"Journal of National Institute of Neurosciences Bangladesh","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78748906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimorbidity Patterns Among Hospitalized Geriatric Patients in Medicine Wards of a Tertiary Care Hospital in Dhaka City","authors":"S. B. Kalam, Sadia Islam, Mohammad Hamza Abdullah Khan, Tanjina Akhter","doi":"10.3329/jninb.v7i1.54754","DOIUrl":"https://doi.org/10.3329/jninb.v7i1.54754","url":null,"abstract":"Background: Elderly people are posing a significant health burden in our country for their multi morbidity as economic growth has increased our life expectancy. Pattern of multi morbidity of this older people varies according to geography, ethnicity, culture and life style. \u0000Aim: The aim of this study was to identify the prevalence and pattern of multi morbidity of elderly patients admitted in a tertiary care hospital. \u0000Method: 50 random cases of elderly patients aged more than 60 years admitted in medicine and allied wards of Dhaka medical college hospital were observed at this cross-sectional study from January 2017 to June 2017(total 6 months period). Data were reviewed and analyzed using simple frequency and percentage. Protocol was reviewed by institutional ethical board (IRB) of Dhaka medical college hospital. \u0000Result: A total number of 50 elderly patients with age ranging from 60 to 95 years were observed with male and female ratio 1.3:1 having multi morbidity among 92.0% patients and female is more affected than male. Hypertension, ischemic heart disease, diabetes mellitus and stroke were found most common diseases as individual. Hypertension and diabetes mellitus was found as the most common multi morbidity pattern followed by hypertension and IHD, stroke & diabetes mellitus. \u0000Conclusion: This study sheds light on priority needs of elderly patients in terms of medical facility in tertiary care hospital of Bangladesh. \u0000Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 56-59","PeriodicalId":16732,"journal":{"name":"Journal of National Institute of Neurosciences Bangladesh","volume":"149 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74944459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pattern of Stroke and Short Term Outcome of COVID-19 Patients admitted in a Dedicated Stroke Unit at Referral Neurology Hospital of Bangladesh","authors":"S. Das, R. Chowdhury, Moniruzzaman, M. E. Hussain, Q. Mohammad, B. A. Mondal, Jahirul Haque Chowdhury","doi":"10.3329/jninb.v7i1.54747","DOIUrl":"https://doi.org/10.3329/jninb.v7i1.54747","url":null,"abstract":"Background: COVID-19 was declared as a pandemic by WHO on March 11, 2020. Though the most common and important presentation is with respiratory disease, reports of neurological features are increasing. \u0000Objective: In this study it was described the pattern of stroke in COVID-19 patients admitted in a dedicated stroke unit and their short term outcome. \u0000Methodology: This single arm, single centreprospective cohortstudy was conducted in the Stroke Unit of National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from April to August, 2020 and wasincluded acute stroke patients irrespective of age and sex who were found RT-PCR positive for SARS CoV-2. The patientswere evaluated clinically, biochemically and by imaging. After diagnosis patients were referred to a COVIDdedicated hospital and were followed up over phone for 4 weeks from the day of admission in stroke unit to assess short term outcome. \u0000Results: Among the 41 patients, 21 were male and 20 female with an age range of 26 to 90 years where 58.5% patients were aged 60 and above. Majority (58.5%) of them came from different urban areas. Common co-morbidities were Hypertension (68.3%) and Diabetes mellitus (39%). Most common presenting features were hemiplegia (48.8%) and altered level of consciousness (39%). More than seventy percent (70.7%) patients had GCS of 10 or less and 56.1% patients had oxygen saturation 90% or less in room air. CT brain imaging revealed infarct in 39% and hemorrhage in 51.2%. Chest radiography revealed abnormality in 14.6% cases. Regarding the short term outcome, total 20 (48.8%) patients died where 7 died before referral to COVID-19 dedicated hospital. Death was higher in hemorrhagic stroke but there was no significant association between outcome and the type of stroke (p value>0.05). \u0000Conclusions: Hemorrhagic stroke is the most commonly occurring stroke among the COVID-19 patients and associated with p oor outcome. \u0000Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 25-28","PeriodicalId":16732,"journal":{"name":"Journal of National Institute of Neurosciences Bangladesh","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79058015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management Difficulties of Neurological Care during the COVID-19 Pandemic","authors":"Badrul Alam","doi":"10.3329/jninb.v7i1.54742","DOIUrl":"https://doi.org/10.3329/jninb.v7i1.54742","url":null,"abstract":"Abstract not available Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 1-2","PeriodicalId":16732,"journal":{"name":"Journal of National Institute of Neurosciences Bangladesh","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80351989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing the Surgical Outcomes of Extradural Haematoma","authors":"M. Salam, Kalim Uddin, Md Abdullah Yusuf, Md. Mahfuzur Rahman, A. M. Khan, Md. Murshadul Hoque, Md. Rafiqul Islam, Md. Sirajul Islam, Sudipto Kumar Mukharjee","doi":"10.3329/jninb.v7i1.54756","DOIUrl":"https://doi.org/10.3329/jninb.v7i1.54756","url":null,"abstract":"Background: Extradural Haematoma can occur in different reasons. \u0000Objective: The purpose of the present study was to see the factors influencing the surgical outcomes of extradural haematoma. \u0000Methodology: This cross-sectional study was conducted in the Department of Neurosurgery at Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2010 to June 2011 for a period of one year and six months. All patients presented with traumatic head injury having extradural haematoma in any age with both sexes who were underwent surgical or conservative management were selected as study population. The etiologies of head injuries were recorded. \u0000Result: Eighty (80) patients of traumatic head injury within and after 24 hours of head injury were enrolled in this study. In this study road traffic accident was the most common mode of injury which was 51(63.8%) cases followed by fall from height and assault which were 16(20.0%) cases and 13(16.2) cases respectively. Majority patients were recovered in good condition either surgery or conservative management which was 50(62.5%) cases. However, the moderate disability was reported in 17(21.2%) cases. Severe disability was found in 8(10.0%) cases. Persistent vegetative state was found in only 2 cases in conservative treatment. Death was found in 3(3.8%) cases. \u0000Conclusion: In conclusion road traffic accident is the most common mode of injury among the study population that causes extra dura haematoma which has the role as factors that influence the outcomes of the patients. \u0000Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 65-68","PeriodicalId":16732,"journal":{"name":"Journal of National Institute of Neurosciences Bangladesh","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81886398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal COVID-19 with Rare Presentation in COVID Dedicated Hospital of Bangladesh: A Case Report","authors":"R. Anne, Zakirul Islam, F. Noman, F. Hasnat, S. S. Shova, Anjuman Ara","doi":"10.3329/jninb.v7i1.54760","DOIUrl":"https://doi.org/10.3329/jninb.v7i1.54760","url":null,"abstract":"Although Coronavirus disease (COVID-19) can affect all age groups, severity of clinical presentation among children and newborns are milder than in adults. Along with classical symptoms, atypical presentation could be noted in the neonate. We report here a case of neonatal COVID-19 where a newborn infant presented with fever, lethargy, respiratory distress and recurrent seizure. Early detection and prompt management is the prerequisite for limiting transmission and reducing neonatal death rate. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 87-89","PeriodicalId":16732,"journal":{"name":"Journal of National Institute of Neurosciences Bangladesh","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83751580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Evaluation of P-Possum and Cr-Possum Scores in Patient Undergoing Colorectal Cancer Operation","authors":"S. Alam, Ayesha Rahman, A. Ahmed, M. Haque, Nazia Mehnaz Joty, A. Talukder","doi":"10.3329/jninb.v6i2.50767","DOIUrl":"https://doi.org/10.3329/jninb.v6i2.50767","url":null,"abstract":"Background: \"Portsmouth\" modification of POSSUM (P-POSSUM) scoring system used to assess mortality in general surgical patients and “Colorectal” Cr-POSSUM scoring system used for mortality assessment for colorectal patient. \u0000Objective: The purpose of the present study was to estimate the validity of the P-POSSUM (Portsmouth-POSSUM) and Cr-POSSUM (Colorectal-POSSUM) score in predicting the risk of mortality in colorectal cancer patient. \u0000Methodology: This was single centre clinical trial was carried out in the Department of Surgery at Dhaka Medical College Hospital, Dhaka, Bangladesh from November 2013 to April 2014 for a period of six (06) months. Patients of both sex who got admitted in the surgery in-patient department for elective colorectal cancer operations were selected as study population. Both the P-POSSUM and Cr-POSSUM, physiological score, operative score, predicted mortality rate were calculated using an online POSSUM calculator. Based on both P-POSSUM and Cr-POSSUM Scoring, patients were categorized into three risk groups. Then a comparative analysis was performed between the observed and the predicted values as well as the Observed/Predicted ratio (O:P) in all the risk groups. \u0000Results: A total of 50 patients with the median age of 50 (ranging 20 to 72) years were studied. 30 days overall observed mortality was 3(6%) patients. The mean P-POSSUM and C-POSSUM physiological scores were 32.49±2.08 and 13.92±1.30 respectively. However, the operative score was 11.59±1.46 and 8.12±0.24 in P-POSSUM and C-POSSUM respectively. The overall mortality predicted by the P-POSSUM model was 5 patients (19.33±2.87) and mortality predicted by the Cr-POSSUM model was 4 patients (20.66±4.09). \u0000Conclusion: In conclusion both model accurately predicted the risk of postoperative death. Cr-POSSUM provided a better fit to observed results than P-POSSUM. \u0000Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 118-123","PeriodicalId":16732,"journal":{"name":"Journal of National Institute of Neurosciences Bangladesh","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79617885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe Head Injury Management at a Tertiary Care Hospital in Dhaka City","authors":"M. Haque, Monsur Ahmed, F. Haque, S. Islam, R. Modhu, A. Sarker","doi":"10.3329/jninb.v6i2.50779","DOIUrl":"https://doi.org/10.3329/jninb.v6i2.50779","url":null,"abstract":"Background: Severe traumatic brain injury can be a serious condition. \u0000Objective: The purpose of the present study was to see the decompressive craniectomy (DC) of severe traumatic brain injury. \u0000Methodology: This clinical trial was conducted in the Department of Neurosurgery at Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2012 to December 2013 for a period of two (02) years. Patients with the age of 18 years and above, GCS of the patients 8 to 4, severe traumatic brain injury (TBI) with multiple hemorrhagic contusions and midline shift, on CT scan and severe TBI with gradual neurological deterioration were included for this study. Total 60 patients were included. \u0000Result: A total of 60 patients were included in this study. Almost two third 18 (60.0%) patients had favorable outcome (GOS 4 and 5) in group A and exactly two third 20(66.7%) patients had Unfavorable outcome (GOS 1,2 and 3) in group B (p<0.05). In this study 8 patient died among which 5 had GCS 4 and 3 had GCS 5. One patient with GCS 5 became persistent vegetative. Eight patient with good recovery had GCS 8, 7 and 6. Death occurred at mean GCS 9±2.mm of midline shift followed by 8± mm in persistent vegetative, 5.67±2.08 mm in severe disability, 4.5±2.88 mm in moderate disability and 3.38±1.06 mm in good recovery. \u0000Conclusion: Group A had better clinical outcome than group B. So based on statistical analysis it can be concluded that DC is preferable to conservative management in case of severe TBI. \u0000Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 124-128","PeriodicalId":16732,"journal":{"name":"Journal of National Institute of Neurosciences Bangladesh","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88805114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduction of Antimicrobial Resistance and Limiting Use of Antibiotics by the Application of De-escalation and Streamlining: A Review Update","authors":"R. Saha, B. M. M. Uddin","doi":"10.3329/jninb.v6i2.50782","DOIUrl":"https://doi.org/10.3329/jninb.v6i2.50782","url":null,"abstract":"De-escalation is a critical component that lies at the center of antimicrobial stewardship programs. It is a clinically effective concept in reducing infection with drug resistant isolates. Although there is significant and serious shortfalls like establishment of the real impact of de-escalation on antimicrobial resistance development; it is now well demonstrated that there is no harm for patients, whether it genuinely improve clinical outcomes. Further studies are needed to establish the most effective tools to implement de-escalation, particularly in terms of providing clear guidelines to clinicians to enable them to be confident in applying this maneuver in our country. It is interesting that this concept of de-escalation is now being explored in different types of infection. \u0000Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 140-142","PeriodicalId":16732,"journal":{"name":"Journal of National Institute of Neurosciences Bangladesh","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83706109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}