Chattagram Maa-O-Shishu Hospital Medical College Journal最新文献

{"title":"Gallstone Ileus: A Rare Surgical Emergency","authors":"A. Ullah, Md Muzharul Hoq Nasim, A. Salam, Maen Tayeb","doi":"10.3329/cmoshmcj.v21i2.63141","DOIUrl":"https://doi.org/10.3329/cmoshmcj.v21i2.63141","url":null,"abstract":"Background : Gallstone ileus is a rare complication of cholelithiasis and is an uncommon cause of intestinal obstruction accounting for 1%–4% of mechanical bowel obstructions. This usually results from luminal impaction of one or more gallstone. \u0000Case Presentation : A 86-year-old male presented with the history of bilious vomiting for 15 days and abdominal distension for 8 days and diagnosed as a case of intestinal obstruction due to gall stone ileus. He was treated surgically by laparotomy followed by enterotomy and removal of gall stone were performed from the proximal ileum. \u0000Conclusion : Early diagnosis and treatment are important otherwise adverse effect of mechanical bowel obstruction leads to bad prognosis. \u0000Chatt Maa Shi Hosp Med Coll J; Vol.21 (2); July 2022; Page 57-59","PeriodicalId":9788,"journal":{"name":"Chattagram Maa-O-Shishu Hospital Medical College Journal","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78409412","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":"Monkeypox : A Global Health Emergency","authors":"R. Biswas, Md Jalal Uddin","doi":"10.3329/cmoshmcj.v21i2.53598","DOIUrl":"https://doi.org/10.3329/cmoshmcj.v21i2.53598","url":null,"abstract":"Abstract not available \u0000Chatt Maa Shi Hosp Med Coll J; Vol.21 (2); July 2022; Page 1-2","PeriodicalId":9788,"journal":{"name":"Chattagram Maa-O-Shishu Hospital Medical College Journal","volume":"235 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74849963","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":"Efficacy and Safety of Tranexamic Acid in Preventing Rebleeding after Subarachnoid Hemorrhage: A Randomized Controlled Trial","authors":"P. Das, Ashok Kumar Phani, Somen Chowdhury, Shemanta Waddadar, A. M. K. Chowdhury, Mohammad Shamchul Alam, Md Hosna Sadat Patwary, Shuva Das, Shiuly Majumdar, Md Hassanuzzaman","doi":"10.3329/cmoshmcj.v21i2.63124","DOIUrl":"https://doi.org/10.3329/cmoshmcj.v21i2.63124","url":null,"abstract":"Background: Recent studies have indicated that early, short-course therapy with Tranexamic Acid (TXA) along with standard treatment for prevention of ischemia in aneurysmal Subarachnoid Hemorrhage (SAH) may be beneficial in preventing rebleeding and improving outcome. The study aimed to assess the efficacy and safety of short-course early administration of TXA combined with standard treatment to prevent rebleeding after SAH. \u0000Materials and methods: Seventy-four patients suffering from SAH verified on Computed Tomography (CT) scan within 72 hours after the primary hemorrhage were randomized into two treatment arms [37 received TXA and standard treatment (Experimental group), 37 received standard treatments only (Control group)]. TXA 1 gm was given intravenously slowly over 10 minutes, followed by 1 gm iv eight hourly up to a maximum of 72 hours. They were followed up for one month to observe rebleeding and outcome by Glasgow Outcome Scale. \u0000Results: Effective sample size was 70 (35 in TXA, 35 in the no-TXA group) due to the dropout of 4 patients. Out of 70 patients, 21 (30%) had rebleeding, and most of the rebleeding (95.23%) occurred after 72 hours of the initial event. Patients who had rebleeding had comparably lower GCS scores at presentation. Out of 21 rebleeding cases, 20 (95.23%) died within one month from the symptom onset. There was no significant difference (p=0.434) in rebleeding rate in TXA-treated patients (25.7%) versus non-TXA patients (34.3%). Treatment with TXA had no beneficial effect on one-month outcome (p>0.05).The adverse events were similar in the two groups and none of the patients had a seizure. \u0000Conclusions: Early short course TXA was tolerable as add-on to standard treatment of SAH but had no significant beneficial effect in reducing rebleeding and in improving one-month outcome. \u0000Chatt Maa Shi Hosp Med Coll J; Vol.21 (2); July 2022; Page 25-29 ","PeriodicalId":9788,"journal":{"name":"Chattagram Maa-O-Shishu Hospital Medical College Journal","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86502234","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":"Arousal Time from Sedation during Spinal Anaesthesia Given with Propofol and Midazolam for Elective Infraumbilical Surgeries","authors":"Purabi Bardhan, M. Mannan, A. Malik, Sreekanta Chandra Banik","doi":"10.3329/cmoshmcj.v21i2.63089","DOIUrl":"https://doi.org/10.3329/cmoshmcj.v21i2.63089","url":null,"abstract":"Background: Arousal time is variable after sedation with spinal anesthesia after infraumbilical surgeries. Propofol and midazolam have been studied individually using the Observer’s Assessment of Awareness/Sedation (OAA/S) score and different other ways. So this present study was designed to compare the arousal time of sedation for propofol and midazolam using OAA/S scores. \u0000Materials and methods: A total of 60 patients were randomly assigned to receive either propofol (Group A, n =30) or midazolam (Group B, n = 30). All patients of Group A received bolus of propofol (1 mg/kg) followed by infusion at 3 mg/kg/h, Group B received bolus of midazolam (0.05 mg/kg), followed by infusion at 0.06 mg/kg/h. OAA/S score was noted at beginning and again during recovery. The time to achieve OAA/S score 5 was noted. Changes of pulse rate, O2 saturation and satisfaction score were noted. \u0000Results: Among the 60 patients gender distributions where male and female distributed evenly. Age group distributions revealed more patients were gathered in age group 31- 40 years and >51 years. Regarding physical status most of the patients were at ASA physical status 1. It was found that propofol had better outcome than midazolam in terms of arousal time score and patient’s satisfaction score after surgery. \u0000Conclusions: A shorter arousal time from sedation during spinal anaesthesia can be achieved using propofol than arousal time with midazolam. \u0000Chatt Maa Shi Hosp Med Coll J; Vol.21 (2); July 2022; Page 18-21","PeriodicalId":9788,"journal":{"name":"Chattagram Maa-O-Shishu Hospital Medical College Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90349360","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":"Serum D-Dimer in Lacunar Stroke","authors":"Muhammad Fakhrul Islam, M. N. Uddin, Md. Titu Miah","doi":"10.3329/cmoshmcj.v21i2.63125","DOIUrl":"https://doi.org/10.3329/cmoshmcj.v21i2.63125","url":null,"abstract":"Background: Stroke is the third most common cause of death in the developed world as well as is the most common cause of severe physical disability. A good number of studies have shown elevated serum D-Dimer level in acute ischemic stroke. Approximately one quarter of ischemic strokes are caused by lacunar infarct. This study demonstrated serum D-Dimer in Lacunar Stroke. The purpose of the study to find out serum D-Dimer in Lacunar Stroke. \u0000Materials and methods: This cross-sectional study was conducted in Medicine Department, Dhaka Medical College, Dhaka on the patients with diagnosis of first ever acute lacunar Ischemic (LACI) stroke presented within 2 days of onset of symptoms. In this study, total 45 acute LACI cases irrespective of their gender were included and examined in presence of consultant physician, who were admitted from March 2014 to September 2014. \u0000Results: An overall male predominance with a male to female ratio was 2:1 with the mean (SD) age of the study population of lacunar stroke was 57.60 (12.68) years. At the distribution of common risk factors in this study, there were hypertension (n=26, 57%), smoking (n=18, 40%) Diabetes mellitus (n=14, 31.1%), dyslipidemia (n=12, 26.6%) and ischemic heart disease (n=9, 20. %). Accounting the focus point of our study, the mean (SD) value of serum D-Dimer was 0.37 (0.20) mg/L with gender difference in male and female [0.39 (0.20) mg/L Vs. 0.31 (0.19) mg/L]. A regression analysis was done to find the association of D-Dimer category group (Dependent variable) which were categorized as Normal range [D-Dimer level <0.5 mg/L (n=29)] and Increased level [D-Dimer level ³0.5 mg/L (n=16)] according to normal cutoff point of D-Dimer (<0.5 mg/L). It shows there was no statistically significant difference among normal and raised D-Dimer with gender, age, smoking, Tobacco, family history of CVD, hypertension, Diabetes mellitus, and dyslipidemia (p value > 0.05). But here, male and dyslipidemia patients were respectively 3.23 and 3.84 times more prone to develop increased level of D-Dimer, but it was statistically nonsignificant. \u0000Conclusion: In this study, it was found that serum D-Dimer was not significantly raised with Lacunar stoke patients. Though lacunar stroke is diagnosed specially by imaging methods, serum D-Dimer may play a role in diagnosis process to exclude from non-lacunar stoke. \u0000Chatt Maa Shi Hosp Med Coll J; Vol.21 (2); July 2022; Page 30-34","PeriodicalId":9788,"journal":{"name":"Chattagram Maa-O-Shishu Hospital Medical College Journal","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74029485","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":"Evaluation of the Weightage on Pain Management in Pharmacology Curricula of MBBS Course in Bangladesh","authors":"J. Ferdoush, F. Johora, F. Jeenia, Tashfia Momtaz Chowdhury, H. Sadia, Rafana Arifina, A. Abbasy, M. Rahman","doi":"10.3329/cmoshmcj.v21i2.63129","DOIUrl":"https://doi.org/10.3329/cmoshmcj.v21i2.63129","url":null,"abstract":"Background: Prioritizing problem-oriented undergraduate medical education is paramount to adequate management of pain in real life scenarios. The present research was conducted with an attempt to explore the important baseline information for pain medicine education and evaluation within pharmacology curricula of MBBS course in Bangladesh. \u0000Materials and methods: This descriptive cross-sectional study evaluates the curriculum (Pharmacology of MBBS curriculum, 2012), and written question (SAQ) of MBBS Examination of last ten years extending from January 2010 to November,2019 of all 7 universities offering MBBS degree. The evaluation was conducted through searching certain key phrases. \u0000Results: In Pharmacology and Therapeutics portion of the curriculum, only 4 hours and 2 hours are allocated to discuss pain management in lecture and tutorial respectively. In the study period, average marks allocated in pharmacology written question papers was 4.4 (SD ± 2.7) and the difference among studied universities was not significant (p value 0.7). \u0000Conclusion: Allocated time in the curricula to teach pain management is very low and weightage received in assessment is also inadequate. Education on pain medication as well as management should receive more emphasis. \u0000Chatt Maa Shi Hosp Med Coll J; Vol.21 (2); July 2022; Page 48-51","PeriodicalId":9788,"journal":{"name":"Chattagram Maa-O-Shishu Hospital Medical College Journal","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75301733","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":"News & Views Vol. 21(2)","authors":"M. J. Uddin","doi":"10.3329/cmoshmcj.v21i2.63154","DOIUrl":"https://doi.org/10.3329/cmoshmcj.v21i2.63154","url":null,"abstract":"Abstract not available \u0000Chatt Maa Shi Hosp Med Coll J; Vol.21 (2); July 2022; Page 67   ","PeriodicalId":9788,"journal":{"name":"Chattagram Maa-O-Shishu Hospital Medical College Journal","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88362220","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":"Comparison between Interrupted X Suture and Continuous Suture for Closure of Midline Incision in Emergency Laparotomy : A Randomized Controlled Trial","authors":"Jasmin Begum, A. Ullah, Iftekharul Islam, Md. Al-Amin Chowdhury, Md. Abdullah Al Mansur, Utpak Kumar Das","doi":"10.3329/cmoshmcj.v21i2.63130","DOIUrl":"https://doi.org/10.3329/cmoshmcj.v21i2.63130","url":null,"abstract":"Background: Wound dehiscence is disruption of any or all of the layers in a wound. At around 7–10 days post operatively leakage of clear sero-sanguinous fluid from the wound is usually the first indicator of burst abdomen. The patient usually feels something ‘giving away’ at this time.It may occur in 3-14.5% cases and is very distressing to the patient.Number of methods of closure of midline laparotomy wound have been introduced in the past to prevent this outcome. The study to compare the result of continuous and interrupted closure of midline emergency laparotomy in respect of burst abdomen. \u0000Materials and methods: This randomized controlled trial study was carried out in the Department of Surgery Chittagong Medical College Hospital, Chattogram, duration January 2017 to December 2017. A total of 500 patients were enrolled in this study. Data were collected, statistical analyses were obtained by using window based computer software devised with Statistical Packages for Social Sciences (SPSS-23). \u0000Results: 250 patients in group A and 250 in B. Surgical wound related post-operative complications were found in 30.4% of the study subjects (n=152).Wound dehiscence was found in 11% subjects, surgical site infection was found in 18.4% subjects and incisional hernia in 1%.All these complications were significantly higher in continuous suture group than interrupted group (p<0.001).Wound dehiscence in 20 subjects, treated with interrupted sutures and in 40 subjects (35 wound dehiscence and 5 incisional hernia)treated with continuous suture. The Relative Risk (RR) of developing wound dehiscence post-operatively was found to be 0.63 (95% CI 0.33 – 0.72) for interrupted suture. This was statistically significant (p<0.05). \u0000Conclusion: The interrupted X suture technique is better than continuous suture technique in prevention of burst abdomen in emergency midline laparotomy. \u0000Chatt Maa Shi Hosp Med Coll J; Vol.21 (2); July 2022; Page 52-56","PeriodicalId":9788,"journal":{"name":"Chattagram Maa-O-Shishu Hospital Medical College Journal","volume":"86 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85065651","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 Self-Reported Behavioural Risk Factors of Non-Communicable Diseases among Doctors Working in a Tertiary Care Hospital","authors":"S. Sarkar, Raju Dey, B. Chowdhury, Shahryar Ahmed, Sagar Chowdhury","doi":"10.3329/cmoshmcj.v21i2.63088","DOIUrl":"https://doi.org/10.3329/cmoshmcj.v21i2.63088","url":null,"abstract":"Background: Behavioural risk factors reduction is a key to Non-Communicable Diseases (NCDs) control. The doctors are educated and aware of society, yet their lifestyle and work habits have led them to suffer from NCDs. This study was carried out to determine the prevalence of the behavioral risk factors of major NCDs among doctors working at Chittagong Medical College Hospital (CMCH). \u0000Materials and methods: This cross-sectional study included 145 doctors working at CMCH from April 2020 to September 2020. A structured self-administered questionnaire based on the WHO STEPS instrument for NCDs risks factors surveys was used to collect data. \u0000Results: Out of 145 respondents, 104 doctors (71.7%) were males, and 41 doctors (28.3%) were females. Most doctors (50.3%) were aged 23 to 35 years and 29.7% were 35-44 years. The proportion of doctors currently smoking tobacco, drinking alcohol, being sedentary in daily life, and taking low vegetables and fruits was 8.3%, 8.3%, 18.6%, and 72.4%, respectively. No female doctor reported smoking or drinking. Ninety-one (62.8%) of doctors had one risk habit and 17.2% with two risk habits. \u0000Conclusion: It is desirable that doctors voluntarily strive to have a favourable lifestyle and that medical institutions actively enlighten doctors’ working at their institutions about this issue. \u0000Chatt Maa Shi Hosp Med Coll J; Vol.21 (2); July 2022; Page 14-17","PeriodicalId":9788,"journal":{"name":"Chattagram Maa-O-Shishu Hospital Medical College Journal","volume":"116 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82108137","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":"Diagnostic Accuracy of Urinary Reagent Strip to Determine CSF Chemistry and Cellularity","authors":"Shemanta Waddadar, A. M. K. Chowdhury, Rajsree Chowdhury, P. Das, Mohammad Shamchul Alam, M. Rubel, S. Majumder, M. Hassanuzzaman","doi":"10.3329/cmoshmcj.v21i2.63087","DOIUrl":"https://doi.org/10.3329/cmoshmcj.v21i2.63087","url":null,"abstract":"Background: Cerebrospinal Fluid (CSF) examination is a common investigation to diagnose and evaluate different neurological diseases. The gold standard method of CSF examination is microscopy, biochemistry and culture in a standard laboratory, which require an experienced microscopist and laboratory support. Urinary reagent strip can be a point of care test in such condition. The study aimed to document the diagnostic accuracy of urinary reagent strip for the semi-quantitative analysis of CSF chemistry and cellularity. \u0000Materials and methods: One hundred hospitalized patients from the Department of Neurology, Chittagong Medical College Hospital were included in this study. CSF samples of the patients were subjected for the de nitive test (CSF microscopy and laboratory biochemical values) and the index test [Combur-10 urinary reagent strip was used as the index test for protein, glucose, leukocytes and erythrocytes. The diagnostic accuracy of each index test was calculated using different cut-off levels (Glucose 1+ vs. CSF glucose >50 mg/dL, protein 1+ vs. CSF protein >30 mg/dL, leukocyte esterase 1+ positivity vs. >10 granulocytes/mm3 and erythrocyte 1+ positivity versus >5 RBC/mm3 in CSF sample). \u0000Results: The diagnostic accuracy of protein estimation by reagent strip shows 100% sensitivity, 84.21% specificity for detection of CSF protein at level 30mg/dl. Glucose reagent strip positivity had 98.8% sensitivity and 75% specificity for detection of CSF glucose at level 50 mg/dl. Leukocyte esterase positivity by test strip had sensitivity of 60% and specificity of 100% for the detection of CSF granulocyte of >10 granulocytes/mm3. The diagnostic accuracy of erythrocyte estimation by reagent strip show 92% sensitivity, 92% specificity for detection of CSF RBC >5 cells/mm3. \u0000Conclusion: Urinary reagent strip can be used routinely for rapid analysis of CSF.A resource-limited hospital might find it useful as a point-of-care laboratory workup of CSF. \u0000Chatt Maa Shi Hosp Med Coll J; Vol.21 (2); July 2022; Page 9-13","PeriodicalId":9788,"journal":{"name":"Chattagram Maa-O-Shishu Hospital Medical College Journal","volume":"87 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82212823","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}