Journal of Enam Medical College最新文献

{"title":"Similarities between Preexplorative Diagnosis and Perexplorative Findings of Intestinal Obstruction Patients in Two Tertiary Care Hospitals in Bangladesh","authors":"S. Akter, D. Paul, D. Das","doi":"10.3329/jemc.v9i3.43243","DOIUrl":"https://doi.org/10.3329/jemc.v9i3.43243","url":null,"abstract":"Background: Intestinal obstruction is a common surgical problem that surgeons face in clinical practice. Still intestinal obstruction is a major problem in medical college hospitals in Bangladesh. Causes of intestinal obstruction remain same as earlier. There is lack of statistical data in our country. So, this study will be helpful in various aspect of management of intestinal obstruction patients by providing data. \u0000Objective: To find out similarities between preoperative diagnosis with actual peroperative findings of intestinal obstruction. \u0000Materials and Methods: This cross-sectional study was conducted from April 2013 to April 2014 at Enam Medical College Hospital and Dhaka Medical College Hospital. Two hundred patients were selected by purposive sampling of diagnosed cases of intestinal obstruction. \u0000Results: Among the subjects male were 124 (62%) and female were 76 (38%). Mean age was 34.56 ± 9.13 years. The maximum respondents were from 21–30 years age group (54%) followed by 31–40 years (18%) age group. Chronic intestinal obstruction was present in 53% cases and acute intestinal obstruction in 47% cases. The clinical profile showed that all patients had abdominal pain followed by vomiting (78%). The preoperative diagnosis of intestinal obstruction was neoplastic obstruction (24%) followed by obstructed hernia (22.5%). The highest similarities (100%) were observed in case of volvulus and ileosigmoid knotting. Obstructed hernia had the highest accuracy (97.7%) followed by neoplastic obstruction (91.66%). Maximum patients (13.5%) suffered from wound infection followed by burst abdomen (3%). \u0000Conclusion: The preoperative diagnoses are very much similar to peroperative findings. The clinical parameters and other mandatory diagnostic tools commonly used in tertiary level hospitals in our country showed diagnostic accuracy in diagnosis of intestinal obstruction. \u0000J Enam Med Col 2019; 9(3): 155-159","PeriodicalId":30472,"journal":{"name":"Journal of Enam Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46764838","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":"Impact of Promotional Activities of Pharmaceutical Companies over Prescribing Practices of Health Professionals","authors":"Z. Rahman","doi":"10.3329/JEMC.V9I2.41407","DOIUrl":"https://doi.org/10.3329/JEMC.V9I2.41407","url":null,"abstract":"Abstract not available \u0000J Enam Med Col 2019; 9(2): 72-73","PeriodicalId":30472,"journal":{"name":"Journal of Enam Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3329/JEMC.V9I2.41407","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45167725","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":"Study on Risk Factors and Microorganisms for Surgical Site Infection following Caesarean Section among 100 Patients in a Tertiary Hospital in Bangladesh","authors":"Sayma Afroz, M. Rashid","doi":"10.3329/JEMC.V9I2.41410","DOIUrl":"https://doi.org/10.3329/JEMC.V9I2.41410","url":null,"abstract":"Background: Lower uterine caesarean section is a common mode of delivery now and surgical site infection is one of the most common and dreaded complication of surgery. It is associated with significant morbidity and delayed recovery and it lengthens hospital stay and costs. Identifying risk factors for surgical site infection in caesarean wound and modifying them can be beneficial for patient management during surgery and optimizing good clinical outcome. Identifying microorganisms with their sensitivity has epidemiological as well as therapeutic implications. \u0000Objective: To identify risk factors for surgical site infection in caesarean section wound and find out microorganisms responsible for such infection. \u0000Materials and Methods: In this study 100 women with surgical site infection after caesarean section were included. They were selected randomly from four maternity units of Dhaka Medical College Hospital. Each patient of caesarean section was followed strictly up to discharge from hospital and also for 30 days postoperatively for any evidence of infection. Wound swab was sent in each case for microbiological study. Data were collected in structured questionnaire and analysed by computer using spreadsheet. \u0000Results: Among 100 women studied, 73% had inadequate or no antenatal check-up, 52% had duration of labour pain >12 hours, 52% had duration of ruptured membrane >12 hours, 94% women underwent emergency caesarean section, 62% had operation time >1 hour, 61% had haemoglobin level <60%, 46% women had intervention by untrained birth attendant, and 43% women had >500 mL blood loss during operation. In bacteriological study, microorganisms were identified in 55% cases, among them Staphylococcus aureus (20%), E. coli (11%), Acinetobacter (7%), Pseudomonas (6%) and Proteus (5%). During sensitivity test Staphylococcus aureus was mostly sensitive to ceftriaxone (50%) and amikacin (33%) and E. coli to amikacin (80%). In four cases (2 proteus and 2 pseudomonas) out of 55 organisms were resistant to all antibiotics. \u0000Conclusion: Most of the risk factors for surgical site infection during caesarean section identified in this study can be modified through intervention. However, the microorganisms detected from our patients showed a high degree of resistance for commonly prescribed antimicrobials in our set-up. \u0000J Enam Med Col 2019; 9(2): 90-96","PeriodicalId":30472,"journal":{"name":"Journal of Enam Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3329/JEMC.V9I2.41410","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43145601","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":"Clinical and Endoscopic Profile of Patients with Upper Gastro-Intestinal Bleeding (UGIB)","authors":"I. Perveen, Q. Hasan, Abu Mosabbir","doi":"10.3329/JEMC.V9I2.41408","DOIUrl":"https://doi.org/10.3329/JEMC.V9I2.41408","url":null,"abstract":"Background: Upper gastro-intestinal bleeding (UGIB) is a cause of significant morbidity and mortality. Prevalence as well as mortality is higher in elderly persons above sixty years because of increasing use of nonsteroidal anti-inflammatory drugs and associated comorbidity. Conventionally upper GI bleeding is divided as variceal and nonvariceal sources and the treatment protocol varies accordingly. There are limited data regarding UGIB in our country. \u0000Objective: This observational study was designed to delineate the clinical and endoscopic profile of patients with UGIB in our country. \u0000Materials and Methods: This prospective observational study was done in the Department of Gastroenterology in Enam Medical College & Hospital during the period of 2014–2017. Patients with UGIB were followed until discharge or death. Patients were subjected to upper GI endoscopy, preferably within the first 24 hours. Clinical and endoscopic data of 131 patients were compiled and analyzed in this study. The data were analysed using SPSS version 21.0. \u0000Results: Among the 131 final participants 101 were male and 30 were female. Mean age of the patients was 43.65 ± 18.63 years. Patients mostly presented with both haematemesis and melaena (66, 50.4% patients), 33.6% with haematemesis only, and 16% patients with melaena only. The most common endoscopic finding was duodenal and or gastric ulcer (57); next common lesions were gastric/duodenal erosions (23), oesophageal varices (13), oesophageal erosions/ulcers (10), corrosive burn (10) and carcinoma (7). Forty patients had history of NSAID intake and gastric/duodenal ulcer and/erosions were the most frequent lesions among them (27). One patient with oesophageal varices died due to rebleeding. \u0000Conclusion: In our study peptic ulcer-related bleeding is the most common cause of UGIB. A significant proportion of UGIB is due to corrosive burn (harpic) emphasizing the need for public awareness. Mortality was due to rebleeding. \u0000J Enam Med Col 2019; 9(2): 78-83","PeriodicalId":30472,"journal":{"name":"Journal of Enam Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3329/JEMC.V9I2.41408","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48220525","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":"Bithalamic Infarct ― Sequel of Vein of Galen and Internal Cerebral Vein Thrombosis","authors":"S. Mosharraf","doi":"10.3329/JEMC.V9I2.41418","DOIUrl":"https://doi.org/10.3329/JEMC.V9I2.41418","url":null,"abstract":"Abstract not available \u0000J Enam Med Col 2019; 9(2): 140-142","PeriodicalId":30472,"journal":{"name":"Journal of Enam Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3329/JEMC.V9I2.41418","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48479275","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":"Reviewers in this Issue Vol.9(2)","authors":"E. Chief","doi":"10.3329/jemc.v9i2.41420","DOIUrl":"https://doi.org/10.3329/jemc.v9i2.41420","url":null,"abstract":"Abstract not available \u0000J Enam Med Col 2019; 9(2): 144","PeriodicalId":30472,"journal":{"name":"Journal of Enam Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43952738","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":"Drug Management Pattern and Their Adverse Effects in Patients of Cervical Carcinoma Attending Two Tertiary Care Hospitals in Dhaka City","authors":"S. Afrin, Syed Ehsan Noor","doi":"10.3329/JEMC.V9I2.41412","DOIUrl":"https://doi.org/10.3329/JEMC.V9I2.41412","url":null,"abstract":"Background: Cervical cancer remains a significant health burden worldwide. It is the second most commonly diagnosed cancer and third leading cause of cancer death among females in least developed countries. There were an estimated 527,600 new cervical cancer cases and 265,700 deaths worldwide in 2012. Bangladesh stands 11th in the world in cervical cancer fatalities with 17.9 women dying in 100,000 due to the largely sexually transmitted disease every year. \u0000Objective: The present study was done to evaluate the pattern of drug management, their adverse effects and socio-demographic characteristics of the patients of cervical carcinoma admitted and treated with chemotherapy in two tertiary care hospitals of Bangladesh. \u0000Materials and Methods: It was a cross-sectional observational study carried out from January to December 2015 at Dhaka Medical College & Hospital and National Institute of Cancer Research Hospital. During this period, 109 patients were selected by purposive sampling technique using a set of pre-tested structured questionnaire. Data analysis was done using SPSS version 21.0. \u0000Results: Most of the patients were in 5th decade (51.4%), from low (59.6%) income family and were married (98.16%). The mean duration of treatment for cancer was found 11.34 ± 5.32 months. Cisplatin (93.57%), 5 fluorouracil (63.3%) and paclitaxel (12.8%) were the most frequently prescribed drugs either alone or in combination. The adverse effects for cisplatin were gastrointestinal toxicity, nephrotoxicity, myelosuppresion and for 5-fluorouracil were myelosuppression, diarrhea, hyperpigmentation, dizziness, neuropathy, increased risk of infection. \u0000Conclusion: The combination of cisplatin and 5-fluorouracil was mostly (50.45%) prescribed followed by cisplatin alone (26.6%) to treat the patients of cervical carcinoma in Bangladesh. \u0000J Enam Med Col 2019; 9(2): 104-109","PeriodicalId":30472,"journal":{"name":"Journal of Enam Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3329/JEMC.V9I2.41412","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43884951","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":"Recovery from Leptospira-Related Acute Liver Failure and Acute Kidney Injury ― A Case Report from Bangladesh","authors":"Akmat Ali, R. Gomes, K. Begum","doi":"10.3329/JEMC.V9I2.41417","DOIUrl":"https://doi.org/10.3329/JEMC.V9I2.41417","url":null,"abstract":"Leptospirosis is a zoonosis with protean manifestation caused by the spirochete, Leptospira interrogans. Here we report a 60-year-old male who presented with sudden onset of fever, rigors, myalgia and headache occasionally accompanied by nausea, vomiting and diarrhea. Later during the course of treatment he developed encephalopathy with fulminant hepatic failure and acute kidney injury and was diagnosed as a case of leptospirosis. A timely workup combined with early initiation of antibiotics and hemodialysis led to effective treatment for this patient. \u0000J Enam Med Col 2019; 9(2): 136-139","PeriodicalId":30472,"journal":{"name":"Journal of Enam Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3329/JEMC.V9I2.41417","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48041796","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 of Hollow Viscus Injury following Gunshot at Casualty Department of Dhaka Medical College & Hospital","authors":"A. Sarker, H. Zim","doi":"10.3329/JEMC.V9I2.41413","DOIUrl":"https://doi.org/10.3329/JEMC.V9I2.41413","url":null,"abstract":"Background: Gunshot injuries result from the effect of a bullet or projectiles emanating from the use of firearms. Firearm injuries are associated with substantial emotional, physical and financial burden causing an enormous human toll and imposing huge costs on the society. Abdominal injuries are associated with a high incidence of internal injury. These injuries are increasingly seen in many developing countries, which have been attributed to communal and ethnic clashes, political violence and armed robberies. \u0000Objective: The objective of this study was to determine the overall outcome of hollow viscus injury following gunshot on the basis of time duration of presentation and amount of blood loss at the time of presentation. \u0000Materials and Methods: This observational study was conducted at casualty department of Dhaka Medical College & Hospital over a period of one year from October 2014 to October 2015. All admitted patients with hollow viscus injury due to gun shot at casualty department of DMCH were included in this study by selective sampling technique. The main outcome variables were postoperative wound infection, anastomotic leakage, number of deaths and prolonged hospital stays. Data processing and analysis were done using SPSS 17.0. \u0000Results: There were total 76 patients with hollow viscus injury following gunshot during the period under review. All were male patients with mean age 31.13 years. Peak incidence occurred within age group 41–60 (52.6%). The most commonly injured organs were the small bowel in 34 patients (44.7%). Thirty (90.9%) patients presented within three hours of the event (p=0.001). Among six patients who died, 5 (83.8%) presented 10 hours after the event (p=0.001). Among 20 patients, 18 (90%) remained hospitalized more than 15 days, who presented within 4–6 hours of the event (p=0.001). In 29 out of 33 patients (87.9%) who did not suffer from any complications encountered only less than 15% of blood loss at the time of presentation (p=0.001). Among 15 patients who suffered from postoperative wound infection nine patients (60%) lost 30–40% of blood at the time of presentation (p=0.011). \u0000Conclusion: Outcome of the patients with hollow viscus injury following gunshot were found to be related to the time taken to reach the casualty department from the place of event and the amount of blood loss at the time of presentation. \u0000J Enam Med Col 2019; 9(2): 110-115","PeriodicalId":30472,"journal":{"name":"Journal of Enam Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3329/JEMC.V9I2.41413","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45357970","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":"Role of Resistance Index in Differentiation of Benign and Malignant Breast Masses Compared with Histopathological Diagnosis","authors":"Mashah Binte Amin, Tarana Yasmin, Samar C Sarkar, Khaleda Parvin Rekha, Rushaida Haque Leeba, N. Akhter","doi":"10.3329/JEMC.V9I2.41411","DOIUrl":"https://doi.org/10.3329/JEMC.V9I2.41411","url":null,"abstract":"Background: Breast tumor remains a worldwide public health problem for women. Linear array sonography is currently one of the main diagnostic methods for detecting breast lumps. Duplex color Doppler sonography has been helpful to distinguish malignant from benign breast disease and also to predict the disease prognosis. \u0000Objectives: The purpose of this study was to evaluate the role of spectral Doppler as a method to measure the vascular resistance index in differential diagnosis between the benign and malignant breast neoplasm. \u0000Materials and Methods: This cross-sectional study was carried out in department of Radiology & Imaging of Enam Medical College & Hospital during January 2015 to December 2017. Sonography was done in 153 women having breast lumps. Among them histopathology was done in 105 cases. Ultrasonographic findings and histopathological report analyses were done using SPSS 13.0. \u0000Results: The study was done in 105 women with mean age 31.6 ± 4.5 years. On ultrasonogram, lesions were diagnosed as benign in 65 (62%) cases and malignant in 40 (38%) cases. Out of sonographically diagnosed 65 benign lesions having peripheral vascularity and decreased RI, 63 (97%) were proved benign histopathologically. With these criteria for diagnosis of benign lesion, sensitivity was 94%, specificity 92%, positive predictive value 95%, negative predictive value 89% and accuracy 93%. Sonographically 40 lesions were diagnosed as malignant. Among them 37 (92.5%) cases were proven malignant histopathologically and showed central vascularity and increased RI having sensitivity of 92%, specificity 94%, positive predictive value 89%, negative predictive value 95% and accuracy 93%. \u0000Conclusion: The analysis of vascular resistance index combined with findings on grayscale sonographic images correlates well with histopathological reports and can be of great assistance in the assessment of breast masses with high sensitivity and specificity. \u0000J Enam Med Col 2019; 9(2): 97-103","PeriodicalId":30472,"journal":{"name":"Journal of Enam Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3329/JEMC.V9I2.41411","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42746597","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}