Journal of Dhaka Medical College最新文献

{"title":"Effect of Donor Variables on Platelet Yield Among Donor Undergoing Plateletpheresis at Transfusion Medicine Department, Dhaka Medical College Hospital (Experience of 350 Procedures)","authors":"S. Karim, M. Hoque, E. Hoque, K. Islam, A. Mamun","doi":"10.3329/JDMC.V28I2.51154","DOIUrl":"https://doi.org/10.3329/JDMC.V28I2.51154","url":null,"abstract":"Background: The platelet transfusions help in prevention of bleeding related complications and thus prevents morbidity and mortality in thrombocytopenic patients. Platelet transfusion plays an important role in the treatment of haematological, oncological, surgical, and transplant patients. Platelets are transfused by two methods i) by fractionation of whole blood and ii) by platelet apheresis. Over the last decade there has been a trend towards the use of SDPs rather than pooled random donor platelets in thrombocytopenic patients. Optimization of platelet yield is an emerging issue to identify factors which may help in selecting donors to obtain higher platelet yields in shorter time and consequently better clinical outcome. Objective: The quality of single donor platelets (SDP) in terms of yield influences the platelet recovery in the recipient. The aim was to identify the SDP donor factors that influence platelet yield. Methods: The study was undertaken at transfusion medicine department, DMCH from 1 January 2017 to 31st December 2017. The study included 350 plateletpheresis procedures. All procedures were performed according to manufacturer’s manual and standard operating procedure. Results: During the period of study, 350 platelet pheresis donors were studied. All of the donors were male. Platelet yield showed high statistical significance with pre donation platelet count and its indices. (p=0.000). Statistical significant negative correlation was seen between pre donation Hb concentration and the platelet yield. (p =0.005). No statistical significance was seen height (p=0.933), weight (p=0.760) of donor on platelet yield. Conclusion: Platelet recovery in the patient is influenced by the transfused dose of platelets, which in turn is dependent on the quality of the platelet product in terms of yield. Various donor factors such as pre donation platelet count and haemoglobin concentration may affect platelet yield.","PeriodicalId":320976,"journal":{"name":"Journal of Dhaka Medical College","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127835744","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":"Online Consultation during COVID-19 pandemic: Surgery perspectives","authors":"Abul Bashar Md Jamal","doi":"10.3329/JDMC.V29I1.51162","DOIUrl":"https://doi.org/10.3329/JDMC.V29I1.51162","url":null,"abstract":"Abstract not available \u0000J Dhaka Medical College, Vol. 29, No.1, April, 2020, Page 1-2","PeriodicalId":320976,"journal":{"name":"Journal of Dhaka Medical College","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132446729","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":"The Effect of Oral Clonidine at Different Doses on Post-Operative Analgesic and Hemodynamic Status in Upper Abdominal Surgery","authors":"Mohammmad Shaddam Hoshain Mondol, Rajat S Das, A. Ali, Ishrat Jahan Shathi, M. A. Miah, Chowdhury Md Mushfiqur Rahman, K. A. Azad","doi":"10.3329/JDMC.V28I2.51147","DOIUrl":"https://doi.org/10.3329/JDMC.V28I2.51147","url":null,"abstract":"Background: Upper abdominal surgery (likehepatobiliary surgery, gastrectomy, esophagectomy, hepatictomy, and whipples operations that involve large surgical incisions) lead to severe postoperative pain that lead to higher doses of opoids use in post-operative period as a result incidence of unwanted side effect and respiratory complication increase hospital stay and morbidity. To reduce the use of opioids clonidine can be used as a multimodal analgesic approach. It is reported that clonidine 150mcg intravenous (I/V) produce a similar analgesic effect to morphine 5mg in patient after orthopedic surgery. Because of its dose, route, and surgical variation it is very much important to specify the dose for upper abdominal surgery. Material and methods: After considering the inclusion and exclusion criteria the patients were randomized to receive Group: A (2mcg/kg oral clonidine) and Group: B (4mcg/kg oral clonidine), one hour (60minutes) before surgery as an oral premedication. All groups were compared for preoperative analgesic, sedation and anxiety level along with changes of heart rate and mean arterial pressure prior to premedication and post-operative periods as follows VAS (visual analogue","PeriodicalId":320976,"journal":{"name":"Journal of Dhaka Medical College","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124363417","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":"Incidence, risk factors and Microorganisms for post caesarean Surgical Site Infection In A Tertiary Care Centre in Bangladesh","authors":"Shahfinaz Mehzabin, M. Elahi, D. Bar, B. Sinha, T. Akter, N. Alam","doi":"10.3329/JDMC.V28I2.51148","DOIUrl":"https://doi.org/10.3329/JDMC.V28I2.51148","url":null,"abstract":"Background: Surgical site infection (SSI) is a common complication following caesarean section (C-section) and mainly responsible for increased maternal morbidity and higher treatment costs. This study will determine the incidence and risk factors of surgical site infections following caesarean section in Dhaka Medical College Hospital (DMCH). Materials and Methods: This is a retrospective observational study which was conducted among patients having post caesarean surgical site infections attending post-natal outdoor clinic of DMCH from January, 2019 to December, 2019. Data were collected in structured questionnaire. Culturebased microbiological methods were used to identify causal agents in postoperative wounds. Results: Overall SSI rate following caesarian section was 4.44%.Patient related risk factors were inadequate antenatal check-up, emergency procedures, malnutrition (22.44%), anaemia (21.46%) associated comorbidity (59.46%), history of rupture membrane >12 hours (40.98%) and had history of prolonged labour pain >12 hours (16.10%).Surgery related risk factors were repeated per vaginal examinations by untrained birth attendant (21.95%) & duration of surgery>1 hour (62.93%). The most common organisms responsible for SSI were Staphylococcus aureus 44(21.46%) and Escherichia coli 31(15.12%). The most sensitive antibiotics were aminoglycosides, cephalosporin & cloxacillin. Conclusion: Most of the risk factors for surgical site infection following caesarean section identified in this study can be modified through intervention. However the microorganisms detected from our patient showed a high degree of resistance for commonly prescribed antimicrobials in our set-up.","PeriodicalId":320976,"journal":{"name":"Journal of Dhaka Medical College","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117244682","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":"Pain and Functional Outcome with Single dose 25% Dextrose Intra-Articular Injection in Patients with Primary Osteoarthritis of the Knee","authors":"Z. Chowdhury, A. Salek, M. Khasru, Farzana Khan Shoma, S. Islam, Md. Israt Hasan, S. Elias, F. Islam, Masuma Rab, Toufiq Ahmed, Farzana Hossain","doi":"10.3329/JDMC.V29I2.51188","DOIUrl":"https://doi.org/10.3329/JDMC.V29I2.51188","url":null,"abstract":"Introduction: Osteoarthritis (OA) is the most prevalent chronic joint disorder worldwide and is associated with significant pain and disability. The introduction of 25% Dextrose injection has been viewed as an advance in the management of OA knee. Methods: A prospective, randomized clinical trial was conducted with 84 cases in the Physical Medicine and Rehabilitation (PMR) department of BSMMU. Group A, 42 patients received single dose 25% Dextrose injection intra articular 8ml, exercise and ADL; Group B, 42 patients received exercise and ADL. Outcomes were measured by OA specific translated and validated Bengali instrumentWestern Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire and visual analogue scale (VAS 0-10). They were followed up for 6 months. Result: At the initial stage and in week 4, there was no statistical difference between two groups regarding VAS score (as p value was >0.05). But in week 12 and 24, there was highly significant statistical difference regarding VAS score between two groups as the p value was <0.001. Again at the initial stage and week 4, there was no statistical difference between two groups regarding stiffness and physical function score. But in week 12 and 24, there was significant statistical difference regarding stiffness and physical function score between two groups as the p value","PeriodicalId":320976,"journal":{"name":"Journal of Dhaka Medical College","volume":"108 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124053648","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 Analysis of Covid-19 Infections in Children with Cancer in A Tertiary Care Hospital in Bangladesh","authors":"S. Islam, M. Akter, Tanvir Ahmmed, Z. Ara, SM Rezanur Rahman, A. Basher, K. Nahar, A. Morshed","doi":"10.3329/JDMC.V29I2.51193","DOIUrl":"https://doi.org/10.3329/JDMC.V29I2.51193","url":null,"abstract":"Background: Children suffering from cancer are more vulnerable than others. This study performed to outline the clinical characteristics and outcome of children with cancer with severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infection in Dhaka Medical College Hospital, Dhaka. Methods: Clinical data and epidemiologic history of 24 children with cancer with laboratoryconfirmed COVID-19 infection by real-time reverse transcription-PCR (RNA-PCR) were admitted in the Dhaka Medical College Hospital, Dhaka from May, 2020 to June, 2020. Clinical data and epidemiologic history of these patients were restrospectively collected and analyzed. Results: Among the 24 cases, 16 (67%)were males and 8 (33%) were females. The median age was 5 years (range 0.11–12 years). The most common symptoms were fever (11 cases, 45%) and runny nose (8 cases, 33%), cough (8 cases, 33%), 6 (24%) were asymptomatic. Acute Lymphoblastic Leukemia were the most common (50%) and second most were Wilms tumor (17%). Among the 24 cases, on admission, 17 (71%) had normal white blood cell counts, while only 2 (8%) more than 10x109/L and 5 (21%) less than 4x109/L, respectively. 16 cases (67 %) had normal neutrophil count and 7 cases (29%) had neutropenia. Lymphocyte counts were normal in 50% cases, lymphocytopenia in 10 (42%). C Reactive protein and serum ferritin raised in 19(79%) cases, D-dimer raised, prothrombin time, activated partial thromboplastin time raised in 8(33%) cases. X-ray chest was abnormal in 6 cases (25%). 16 cases (66%) received intravenous antibiotics, 5 cases (21%) needed oxygen therapy and 4 cases (17%) needed corticosteroid. Ninteen (79%) patients were discharged from hospital, 3cases (13%) were discharged on request and death was 2 cases (8%). Conclusions: Children at all ages appeared susceptible to COVID-19 and there was significant gender difference. Clinical manifestations of children’s COVID-19 cases were generally less severe than those of adult patients. Death rate is more in children with cancer than others.","PeriodicalId":320976,"journal":{"name":"Journal of Dhaka Medical College","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125897284","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":"Hereditary mucinous ovarian cancer complicated with omental metastasis: A case report","authors":"A. Das","doi":"10.3329/JDMC.V29I1.51176","DOIUrl":"https://doi.org/10.3329/JDMC.V29I1.51176","url":null,"abstract":"Approximately 80% ovarian tumorsare benign, and these arise mostly in young adult females. Malignant tumors are more prevalent in ageing women, between the ages of 45-65 years. Mucinous ovarian cancer represents about 5% of epithelial ovarian cancers (EOC).We have reported a case of mucinous cystadenocarcinoma in 35-year-old lady with metastasis to omentum.Imaging (radiograph & CT scan) studies showed a large right sided pelvic mass with probable origin in the right ovary. Cancer antigen-125 was elevated, while carcinoembrionic antigen and alphafetoprotein were normal. Mutational profiles shown distinct finding, as KRAS mutations positive nevertheless p53 and BRCA mutations are absent. She had undergone total abdominal hysterectomy with bilateral salphingo-oopher-ectomy along with pelvic dissection for removal of lymph nodes at the age of 35. She was given advice for radiotherapy with 3 cycles of che-motherapy with cisplatin and paclitaxel. To the best of our knowledge, this is the one of the littlecase of ovarian mucinous cystadenocarcinoma being reported at a relatively young age, and the first case being reported from Bangladesh.","PeriodicalId":320976,"journal":{"name":"Journal of Dhaka Medical College","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129621830","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":"Haemodynamic Consequences in Immediate Postoperative Period in Comparison between Open and Laparoscopic Cholecystectomy”","authors":"Mst Sabiha Banu, Mohammmad Shaddam Hoshain Mondol, Rajat S Das, A. Ali, Ishrat Jahan Shathi, M. Khatun, K. Rahman","doi":"10.3329/JDMC.V28I2.51155","DOIUrl":"https://doi.org/10.3329/JDMC.V28I2.51155","url":null,"abstract":"Background: Laparoscopic cholecystectomy has emerged as a popular alternative to traditional open cholecystectomy in the management of cholelithiasis. It has several advantages .Pneumoperitoneum and trendelenburg positioning causes release of stress hormones and ultimately changes in hemodynamic parameters. Stretching of peritoneum, abdominal wall associated with postoperative pain. So maintenance of haemodynamic stability, immediate postoperative pain control continues to be a major challenge for the anaesthesiologists. Methods: Sample was selected by non-probability sampling technique in two groups distributed asGroup-L (Laparoscopic cholecystectomy, n=30) and Group-O (opencholecystectomy, n=30). Detailed history taking, physical examination and routine lab investigations were done. Approval of the study was obtained by the local Ethical Committee. Post-operative complications, postoperative pain, frequency and pattern of cardiovascular complications, frequency and pattern of respiratory complications were evaluated and compared between thegroups Result: In both groups female were predominant. In this study haemodynamic status (Heart rate, SBP, DBP, MBP) in different phases of anaesthesia, surgery and postoperative follow-up (at 4 hour, 8 hour, and 12th hour) has been observed. Conclusion: This study confirms the feasibility and safety of laparoscopic cholecystectomy is better than open technique in terms of attenuation of better haemodynamic stability, better postoperative pain control and less requirement of analgesia.","PeriodicalId":320976,"journal":{"name":"Journal of Dhaka Medical College","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129119433","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":"Pregnancy outcome in covid-19 positive women in a covid dedicated hospital","authors":"Fahmida Naz Mustafa, N. Yasmin, Munmun Islam, Shafinaz Mehzabin, Sharmina Siddique, S. Alam","doi":"10.3329/JDMC.V29I2.51191","DOIUrl":"https://doi.org/10.3329/JDMC.V29I2.51191","url":null,"abstract":"Objective: To see the maternal and fetal outcome in covid positive hospitalized pregnant women. Method: It is an observational study done in Mugda Medical College Hospital. Duration was from 23 April, 2020 to 16 June, 2020 . Result : 32 hospitalisedcovid positive pregnant women were studied. 84.4% women were above 25 years and 78% were multigravid. 19% had fever on admission and 59% had H/O fever. 22% had respiratory distress ranging from mild to severe on admission. During the hospital stay 28.2% needed ICU. 57.9% women delivered before completion of 37 weeks, among them. 26.3% were before 34 weeks. 79% women had delivery by Cesarean section and 10.5% had hysterotomy. In this study maternal mortality was 21% and 31.6% was perinatal mortality. There was no vertical transmission to fetus. Conclusion: During thisstudy , it is found that pregnancy outcome was not good in covid positive pregnant women . For the infected mothers early medical supervision and availability of ICU in critical condition is needed for better pregnancy outcome.","PeriodicalId":320976,"journal":{"name":"Journal of Dhaka Medical College","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125103511","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":"Clinicopathological patterns of oesophageal cancer patients attending thoracic surgery Department of Dhaka Medical College Hospital","authors":"M. M. Hasan, Osman Goni, K. Alam, Iftakhar Alam, T. Majumder, Tajul Islam, S. Alam, Ayesha Rahman, S. Ahsan","doi":"10.3329/JDMC.V29I1.51174","DOIUrl":"https://doi.org/10.3329/JDMC.V29I1.51174","url":null,"abstract":"Background: Esophageal cancer is one of the most serious gastrointestinal cancer worldwide, owing to its rapid development and fatal prognoses in most cases. There is a paucity of published data regarding esophageal cancer the study area in particular. This study was conducted to describe the endoscopic and clinicopathological patterns of esophageal cancer in this part of the world. The study provides baseline local data for future comparison. Objectives: The present study is done to highlight the increasing incidence of oesophageal cancer in the population. Methods: Detailed informations were obtained in each cases according to protocol. Complete history was taken either from patient or accompanying attendants. Thorough clinical examination was done. Relevant investigation reports were collected. All the informations were recorded according to fixed protocol. Collected data were classified, edited, coded and entered into the computer for statistical analysis by using SPSS version 19. Results: Among the 50 cases, mean age was 52.92(±10.60) years, minimum age was 30 years and maximum age was 80 years. Maximum 76% were male and 24% were female, male: female ratio was 3.17:1. Socio-economic status of the study population, majority 48% were of lower middle class and 40% were of lower class. Common clinical presentations were dysphagia, regurgitation, significant weight loss and nausea and vomiting which were 100%, 96%, 80% and 14% respectively. Common personal history were smoking, white tobacco chewing, betel nut, betel leaf and alcohol consumption which were 66%, 20%, 92%,92% and 10% respectively. Anatomical site of oesophageal cancer, 48% were middle and lower third oesophageal cancer each. Histopathological type of oesophageal cancer, majority 56% were squamous cell carcinoma of different grades and 40% were adenocarcinoma of different grades. Common clinical staging (TNM) of the oesophageal cancer, T2 disease was 58% followed by T3, 26% and T1, 6%. Considering nodal status most of the cases were NO, 60% with Ni, 24% and N2, 16%. Regarding metastasis, only 18% cases had evidence of metastasis. Regarding treatment options of the esophageal cancer, majority 76% were selected for operative procedure, 10% for chemotherapy, 2% for radiotherapy and the rest of 12% for palliation. Conclusion: In conclusion, common clinical presentations of oesophageal cancer were dysphagia, regurgitation, significant weight loss and nausea and vomiting. Predominant personal history were smoking, white tobacco chewing, betel nut, betel leaf and alcohol consumption. Most of the oesophageal cancers were middle and lower third. Majority of oesophageal cancers were squamous cell carcinoma of different grades. Regarding TNM staging most of the oesophageal cancers were T2 disease.","PeriodicalId":320976,"journal":{"name":"Journal of Dhaka Medical College","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133230969","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}