Journal of Bangladesh College of Physicians & Surgeons最新文献

{"title":"Laparoscopic Assisted Vaginoplasty with Amnion Graft","authors":"A. Mazumder, R. Begum, Reshma Feroze, S. Akther, F. Khan","doi":"10.3329/jbcps.v41i2.64584","DOIUrl":"https://doi.org/10.3329/jbcps.v41i2.64584","url":null,"abstract":"Background: Around 1 in 400–5000 live births of females result in vaginal agenesis, a malformation of the female genital tracts. Using an amnion graft to treat vaginal agenesis is a straightforward, widely accessible, economically advantageous, and physiological surgery that leaves no additional scars on the body. This study sought to ascertain whether individuals with vaginal agenesis may successfully undergo laparoscopic-assisted vaginoplasty utilising amnion as a transplant to create a neovagina.\u0000Methods:Ten cases of vaginal agenesis linked to Mayor-Rokitansky-Kuster-Hauser (MRKH) Syndrome were included in this case series and were hospitalised within a year. The ladies with MRKH condition were either previously married or unable to consummate their marriage due to a blind vagina when they were brought for surgical intervention. To maintain the patency of the neo-vagina, a laparoscopically guided vaginoplasty was carried out as part of the care.\u0000Results:In all but one of the patients, laparoscopy-guided vaginoplasty with an amnion graft was effective. The procedure was stopped when the rectum was hurt, and the harm to the rectum was repaired. Except for one example, the functional outcomes of the neovagina were quite good. None experienced any major postoperative problems. The patients were happy with the postoperative results. Also, the neovagina was psychologically acceptable and sufficiently patent for sexual function.\u0000Conclusion: Over the past few years, the new vaginoplasty technique has developed. The most common practice, however, is a laparoscopic approach using several graft materials. A safe and efficient method for treating MRKH syndrome patients with vaginal agenesis is vaginoplasty with amnion grafts.\u0000J Bangladesh Coll Phys Surg 2023; 41: 177-182","PeriodicalId":89579,"journal":{"name":"Journal of Bangladesh College of Physicians & Surgeons","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45053892","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":"Assessment of Serum Zinc Level in Relation to Different Presentation of Wilson Disease in a Tertiary Care Hospital","authors":"Md Shafiul Alam, Nadia Haq, Morsheda Begum, Farzana Afrooz, Nanda Lal Das, M. Mazumder","doi":"10.3329/jbcps.v41i2.64604","DOIUrl":"https://doi.org/10.3329/jbcps.v41i2.64604","url":null,"abstract":"Background:Wilson disease (WD) is an autosomal recessive disorder of copper metabolism with diverse clinical manifestations. Zinc (Zn) has been used for treatment of WD. Recent studies showed low serum zinc level in patients suffering from WD than the normal.\u0000Objective: This cross sectional observational study has been designed to compare the serum Zinc level in children suffering from different presentation of WD before started treatment.\u0000Methods: This work was carried out at the department of Pediatric Gastroenterology and nutrition, BSMMU, Dhaka between July’ 2018 to June2019. Total 27 children diagnosed as WD disease, aged between three to eighteen years were included in this study. The patients of WD were divided into four groups according to their presentation as acute hepatitis, decompensated liver disease, acute liver failure and Wilson disease with neurological manifestation. Informed written consent were obtained from all patients for participation in this study. Along with other physical findings and laboratory investigations 3 ml of venous blood were collected for estimation of serum Zinc level. After estimation of serum Zinc level results were analyzed statistically. The difference in serum zinc levels were compared between the groups.\u0000Results: Serum Zinc level was founded low in all Wilson disease patients (43.8 ±19.7 [13-83] µg /dl) compared to normal value (64-124µgm. /dl). Among the patients, Serum Zinc level was significantly lower in those who presented as CLD (18 cases, 38.4±17.4µg/dl) and acute liver failure (4 cases, 33.1±3.7µg/dl) compared to those presented as acute hepatitis (4cases, 71.8±4.3 µg/dl) and p value was 0.001 and <0.001 respectively. Mean serum Zinc level was low in 4 patients suffering from acute liver failure (33.1±3.7µg/dl) but was not significant compared to those (23) who presented as Wilson disease non-ALF (45.7±20.8 µg/dl) (P= 0.013) and as Wilson disease CLD (38.4±17.4µg/dl) (p=.25).\u0000Conclusion: Serum Zinc level was lowered in patients of Wilson disease. Serum level of zinc was significantly low in patients presented as CLD and acute liver failure in comparison to patients with acute hepatitis.\u0000J Bangladesh Coll Phys Surg 2023; 41: 126-131","PeriodicalId":89579,"journal":{"name":"Journal of Bangladesh College of Physicians & Surgeons","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41964574","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":"A Case of Imatinib Induced Nephrotic Syndrome in a Child with Chronic Myeloid Leukaemia","authors":"Mumtahena Mahmuda, T. Chowdhury, M. Quader, A. Karim, Joydip Nandy, Md Naoshad Khan","doi":"10.3329/jbcps.v41i2.64507","DOIUrl":"https://doi.org/10.3329/jbcps.v41i2.64507","url":null,"abstract":"Background:Tyrosin kinase inhibitors (TKI) are used as a targeted therapy for the treatment of chronic myeloid leukaemia and Philadelphia chromosome positive acute lymphoblastic leukaemia. Increasing use of TKI has been associated with hypertension, proteinuria and acute kidney injury. There are only afew reports of adults with TK -inhibitor associated nephrotic syndrome.But TK inhibitor associated Nephrotic syndrome is very rare in paediatric age group.\u0000Case:A -6- year old boy presented with fever, anaemia, splenomegaly, leucocytosis and finally diagnosed as accelerated phase of chronic myeloid leukaemia (CML) by bone marrow study.He achieved clinical and haematological remission with Imatinib. But developed generalized oedema and was found to have massive proteinuria and microscopic haematuria after three and half months. Renal biopsy revealed focal segmental glomerulosclerosis. Imatinib along with Prednisolone, 60 mg/m2/ day was added to treat nephrotic syndrome. Imatinib discontinued as the patient did not achieve complete remission. After one week of Imatinib withdrawal and five weeks of daily prednisolone the boy attained complete remission of nephrotic syndrome.\u0000Conclusion:Tyrosine Kinase inhibitors are important therapies in paediatric cancer and their use is expanding. Timely recognition of renal adverse effectsfor TK inhibitors can aid in the proper management of cancer patients.\u0000J Bangladesh Coll Phys Surg 2023; 41: 170-172","PeriodicalId":89579,"journal":{"name":"Journal of Bangladesh College of Physicians & Surgeons","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44289629","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":"Hepatitis C: Present Status and Management","authors":"A. Rowshon","doi":"10.3329/jbcps.v41i2.65151","DOIUrl":"https://doi.org/10.3329/jbcps.v41i2.65151","url":null,"abstract":"Abstract not available\u0000J Bangladesh Coll Phys Surg 2023; 41: 100-101","PeriodicalId":89579,"journal":{"name":"Journal of Bangladesh College of Physicians & Surgeons","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47663387","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":"Outcome of Aspiration Alone and Aspiration with Instillation of Steroid in Ganglion Cyst of Wrist- A Comparative Study","authors":"Hafizur Rashid Sazal, Md Nazmul Haque, Nashid Rahman, Asm Rezwan, Chamina Afroz","doi":"10.3329/jbcps.v41i2.64499","DOIUrl":"https://doi.org/10.3329/jbcps.v41i2.64499","url":null,"abstract":"Background: Ganglion cysts are common soft tissue swellings of hand and wrist. Main concerns patients have are the cosmetic appearance and the fear of future malignancy. Various modalities of treatment are available but known to have high rate of recurrence. Here we study mainly the recurrence rate after aspiration alone and aspiration with instillation of steroid, to compare these minimally invasive procedures that can help to treat and give symptomatic relief from this commonly occurring problem.\u0000Methodology: A Prospective, Comparative study was carried out with purposive sampling to include all patient of Ganglion cyst of wrist. After detail counseling, Patient desired among Aspiration only and Aspiration with instillation of Steroid randomly. All cases were followed up on 3rd, 6th and 12th month. Recurrence data were collected and all data were arranged and analyzed.\u0000Result: Total 113 patients were included in our study, Male female ratio was 1:1.3, Mean age was 31.3 years. 74(65.5%) patient had ganglion on  right wrist and 39 (34.5%) patient had it on left wrist. Dorsal ganglion was 89 (78.8%) and Volar ganglion was 24 (21.2%). In this study 58 (51.3%) patient underwent Aspiration alone, among them total 22 (37.9%) had recurrence. 12 (20.7%) had recurrence of the ganglion within 3 months, followed by 6(10.3%) within 6 month and 4 (6.9%) within 12 month. Aspiration with instillation of steroid was done in 55 (48.7%) patients. Recurrence within 1 year was found in total 16 (29.1%) cases. 4 (7.3%) had recurrence within 3 month and 6 (10.9%) cases each had recurred within 6 and 12 month respectively. Dorsal and Volar ganglion had similar recurrence rate i.e 33% irrespective of type of procedure.\u0000Conclusion: We may conclude that Aspiration with instillation of steroid had better outcome than Aspiration alone but both have significant recurrence rate.\u0000J Bangladesh Coll Phys Surg 2023; 41: 108-113","PeriodicalId":89579,"journal":{"name":"Journal of Bangladesh College of Physicians & Surgeons","volume":"2020 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41297153","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 Biochemical Profile of Children with Chronic Kidney Disease in a Tertiary Care Hospital of Bangladesh","authors":"F. Yasmin, S. Afroz, T. Ferdous, Umme Tanjila, Sukriti Baroi","doi":"10.3329/jbcps.v41i2.64538","DOIUrl":"https://doi.org/10.3329/jbcps.v41i2.64538","url":null,"abstract":"Background: Chronic kidney disease (CKD) is an insidious and irreversible condition that eventually progresses to end stage renal failure and important cause of morbidity and mortality in children worldwide. However, the care of these patients represents a challenge for health care providers, which must pay attention not only to renal disease, but also to the various extra renal manifestations that affect growth and development. Evaluation of clinical and biochemical profile of children with chronic kidney disease can help to meet up this challenge.\u0000Methods:  This cross-sectional observational cohort study evaluated clinical, anthropometric and biochemical variables of children with chronic kidney disease aged 2 to 16 years in the department of Pediatric Nephrology, Dhaka Shishu (Children) Hospital, Bangladesh, during July’ 2018 to December’ 2018. A total of thirty-six children with chronic kidney disease with creatinine clearance <60ml/min/1.73 m2 and on supportive treatment and haemodialysis were included. In control group, equal number of age and sex matched healthy children without any preexisting chronic diseases were included. Both study group and control group were assessed for sociodemographic data, nutritional status, clinical and biochemical parameters.\u0000Results:  The mean age was 9.09±3.01 years in case group and 7.85±3.69 years in control group. In case group, 22 patients (61.1%) were male and 14 (38.9%) were female and the ratio was 1.5:1. In this study we found that a statistically significant decrease in Z-score for (Weight, Height and Body Mass Index) in the CKD patients’ group than control. In terms of blood pressure, 66.7% of patients in the cases group were hypertensive (P = 0.001). There was no significant difference of hypertension among CKD stages in this study. CKD Patients were found anemic with significant decrease in hemoglobin level. Anemia found in 35 patients (97.2%) in the case group than control (P=0.001). CKD stage 5 children had significantly lower hemoglobin level. Serum phosphate and potassium were significantly higher while serum calcium was significantly lower and parathyroid level was higher in case group than control.\u0000Conclusion: The present study stated that CKD patients had significantly lower BMI and hemoglobin but hypertensive in comparison to case group. Serum potassium, phosphate and parathyroid higher but serum calcium level was lower in case group.\u0000J Bangladesh Coll Phys Surg 2023; 41: 120-125","PeriodicalId":89579,"journal":{"name":"Journal of Bangladesh College of Physicians & Surgeons","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69501376","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 Presentation and Outcome of Management of Congenital Heart Diseases Associated with Down Syndrome in a Tertiary Care Hospital","authors":"J. Ferdous, N. Begum, Md. Harun Or Rashid","doi":"10.3329/jbcps.v41i1.63256","DOIUrl":"https://doi.org/10.3329/jbcps.v41i1.63256","url":null,"abstract":"Introduction: Treatment of children with Down syndrome having congenital heart defects has not been reported well in Bangladesh. This study has been carried out to inform practitioners about findings from cases in Combined Military Hospital, Dhaka.\u0000Methods: Three years retrospective observational study (clinical data, hospital course and follow-up) was carried out on 114 patients (49 males and 65 females, age range 1 month to 12 years) who underwent diagnostic and therapeutic work up in the pediatric cardiology department CMH Dhaka between January 2018 and December 2020.\u0000Results: Among 114 patients ,64 were (57%) were infants and 50 were older children (43%) , twenty-five had congestive cardiac failure and eighteen had hypothyroidism. The study showed that 33.3% were atrioventricular septal defect (AVSD), 28.1% were patent ductus arteriosus (PDA),8.75% were tetralogy of Fallot (TOF) ,5.25% were coartation of aorta (COA) ,3.5% were patent ductus arteriosus with coarctation of aorta 3.5%, double outlet right ventricle with pulmonary stenosis were 3.5%, ventricular septal defect were 7% whereas atrial septal defect along with ventricular septal defect were 5.3% ,atrial septal defect were 3.5%, transposition of great arteries with multiple ventricular septal defect were 1.8%.Forty (35%) patients using per cutaneous intervention,had 100% procedural success and no mortality .45 patients underwent surgery,few of them were not operated due to severe pulmonary hypertension.\u0000Conclusion: Congenital heart disease was more frequent in DS children,having worse prognosis.Children with DS required special attention due to increased risk of pulmonary hypertension. Delayed treatment was an important risk factor for poor prognosis.So early diagnosis is needed in order to provide optimal intervention and surgery ,before occurrence of irreversible PAH.\u0000J Bangladesh Coll Phys Surg 2023; 41: 7-14","PeriodicalId":89579,"journal":{"name":"Journal of Bangladesh College of Physicians & Surgeons","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48617052","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":"Case Report - Fibrosarcoma of Ovary","authors":"Julia Akhter Nira","doi":"10.3329/jbcps.v41i1.63264","DOIUrl":"https://doi.org/10.3329/jbcps.v41i1.63264","url":null,"abstract":" \u0000Fibrosarcoma of ovary, a tumour arising do novo or secondary to malignant transformation of benign fibromatous tumours, is an extremely rare malignant sex cord stromal tumour of ovary. As on today, the total number of reported cases throughout the world is not more than hundred, There is no clearcut diagnostic criteria, prognostic factor and treatment modalities. Usually it presents as unilateral solid tumour. It can occur at any age though postmenopausal diagnosis is more frequent. Majority of the patients present with vague abdominal pain and a lump in lower abdomen arising from ovary. Ultrasonographic findings usually reveals unilateral solid homogenous tumour in ovary with uneven echo enhancement and increased vascularity. Serum tumor markers and sex hormones such as CA-125 usually found within normal levels. Peroperative frozen section study often concludes into wrong diagnosis, postoperative histopathological diagnosis usually reveals spindle cells with high mitotic activity with  Background of fibrous tissue. Depending on mitotic activity, cellular atypia associated with haemorhage and necrosis, it is differentiated from benign fibroma with mitotic activity. Immunohistochemistry findings may be positive for vimentin, á-inhibin, SMA, estrogen receptor, progesterone receptor. Ki-67 positive rate is associated with degree of severity of malignancy i.e, grading and prognosis. Our case was having the above features and was confirmed postoperatively by histological and later by histochemistry with positive Vimentin and Ki-67. As there were not enough cases to conclude a final treatment protocol, so far treated cases revealed total cytoreductive surgery followed by postoperative chemotherapy has the better prognosis. A round, solid unilateral heterogenous ovarian tumor should be taken in differential diagnosis of ovarian fibrosarcoma. As this is an extremely rare tumour of the ovary, there is usually no rise of specific tumuor marker, no conclusive diagnostive criteria available at present, clinical studies involving multicentered approach associated with studies at molecular level is a prime requirement for the gynaecologist to diagnose and treat in a better way in future.\u0000J Bangladesh Coll Phys Surg 2023; 41: 89-92","PeriodicalId":89579,"journal":{"name":"Journal of Bangladesh College of Physicians & Surgeons","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46050026","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 Correction of Aortic Coarctation with Left Subclavian Artery and Proximal Descending Thoracic Aorta Aneurysm with moderate Left Ventricular Dysfunction in an adult Female- a case report","authors":"S. Gupta, Mozibul Haque, Jagodananda Roy, Bhabesh C Mandol, M. Uddin, P. Chanda","doi":"10.3329/jbcps.v41i1.63265","DOIUrl":"https://doi.org/10.3329/jbcps.v41i1.63265","url":null,"abstract":"In its simplest form, coarctation of the aorta (CoA) refers to congenital narrowing of the thoracic aorta. Usually, a significant pressure gradient between the arms and legs is suggestive of the diagnosis. With the advancement of aortic imaging in our country many CoA patients are diagnosed at an adult age, but the management still carries a challenge. We reported a case of 30-year-old lady with CoA with an aortic aneurysm involving proximal left subclavian artery with proximal DTA and LV dysfunction.\u0000J Bangladesh Coll Phys Surg 2023; 41: 93-97","PeriodicalId":89579,"journal":{"name":"Journal of Bangladesh College of Physicians & Surgeons","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43935476","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 Congenital Heart Diseases Associated with Down Syndrome","authors":"Md. Anwar Hossain Khan","doi":"10.3329/jbcps.v41i1.63254","DOIUrl":"https://doi.org/10.3329/jbcps.v41i1.63254","url":null,"abstract":"Abstract not available\u0000J Bangladesh Coll Phys Surg 2023; 41: 1-4","PeriodicalId":89579,"journal":{"name":"Journal of Bangladesh College of Physicians & Surgeons","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43800054","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}