Original Research Article
Nov. 3, 2020
The Functional Outcome of the Treatment of Subtrochanteric Fracture of Femur Fixed by Proximal Femoral Nail (PFN)
Dr. Md. Zillur Rahman Siddique, Dr. Md. Shafiqul Islam, Dr. Mst. Rukshana Begum Chowdhury,Dr. Md. Mahafil Haque, Dr. Md. Ziaur Rahman, Dr. Nasreen Haque, Dr. Md. Abul Hasnat, Dr. Md Kamal Hossain
Sch J App Med Sci | 2436-2438
DOI : 10.36347/sjams.2020.v08i11.001
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Objective: In this study our main goal is to evaluate the functional outcome of the treatment of subtrochanteric fracture of femur fixed by proximal femoral nail (PFN). Method: This clinical trial study was conducted at National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Sher-e-Bangla Nagar, Dhaka January 2017 to June 2018. Results: During the study, 40% of the cases femoral nail was fixed within 10 days of occurrence of fracture, while in rest 60% of cases, fixation was done after 10 days of fracture. The mean interval between injury and nail fixation was 10.9 days and the minimum and maximum intervals were 8 and 13 days respectively. Evaluation of outcome 12 months after nail fixation showed that 80% of the patients had good outcome (Haris Hip Score between 80 - 89) and the rest 20% had fair outcome (Haris Hip Score between 70 - 79). Conclusion: From our study we can conclude that, the proximal femoral nail is a safe and reliable implant for the treatment of subtrochanteric fractures of femur. Majority of the patients return to preinjury activities with mild limitations in hip movement.
Original Research Article
Nov. 3, 2020
Clinical Outcome of Neonatal Septicaemia in Bangladesh
Dr. Md. Nurul Islam, Dr. Naimur Rahman Ringku, Dr. Md. Safiqul Islam
Sch J App Med Sci | 2439-2441
DOI : 10.36347/sjams.2020.v08i11.002
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Objective: In this study our main goal is to evaluate clinical outcome of neonatal septicaemiaof tertiary medical college and hospitalin Bangladesh Method: this was a prospective observational and experimental study was carried out at tertiary Medical College and Mitford Hospital, from July 2010 to October 2011 among 80 Preterm babies. Results: The mean (±SD) weight of the babies was 1713.8 (±436.0) gm with a range of 500-2450 total 4(5.0%) babies were extreme preterm (gestational age <28 weeks), 12(15.0%) babies were very preterm (gestational age 28 to <32 weeks) and 64(80.0%) babies were preterm (gestational age 32 to <37 weeks). ampicillin 71(88.8%) and gentamicin71(88.8%) were used in most of the cases, followed by ceftazidime and amikacin in 35(43.8%) cases, meropenem in 8(10.0%) cases, ciprofloxacin in 7(8.8%) cases, metronidazole in 11 (13.8%) cases. Among the organisms acinatobacter were present in 2 (2.5%) patients, citarobacter in 1(1.3%) patient mostly. Conclusion: From our study we can say that, acinatobacter was the most common isolate in our study. Early diagnosis and management is essential for the prevention of morbidity and mortality of neonatal sepsis in the neonatal intensive care unit.
Original Research Article
Nov. 3, 2020
Assessment of Renal Pathology among Saudi Population at Tabuk City-KSA Using Computed Tomography
Alaa Ibrahim Ahmed, Nisreen Hassan, Naglaa Elsir, Amna Moahamed, Nmariq Mohamed, Dalal Albalawi, Nouf Almateri, Maryam Albalawi, Fatimah alshhri
Sch J App Med Sci | 2442-2449
DOI : 10.36347/sjams.2020.v08i11.003
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This was retrospective cross sectional study to assess renal pathology using computed tomography CT was done in King Fahd Specialist hospital _ Tabuk -Saudi Arabia from first February 2020 to May 2020. The problem of study was increase kidney diseases that leads to kidney failure and importance to reduce the risk factors that lead to kidney disease. The objectives of the study were to show the role of CT scan in assessment renal pathology among Saudi population. The data were collected variables using CT scanner unit (Siemens’s) with helical generation, through 30 patients with different clinical disorders for renal pathology. The results revealed that the CT tomography has an effective role in assessment renal pathology with confirmed laboratory investigation with significant confidence at P value (0.00). Researchers recommended that CT scan is better for renal pathology.
Original Research Article
Nov. 6, 2020
Role of Chest X-Ray in Assessing Severity of Pneumonia in Children: A Study in Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh
Mohammad Mahbub Hossain, Abu Ishaque khan, MM Monowara, A.K.M. Khairul Islam
Sch J App Med Sci | 2450-2455
DOI : 10.36347/sjams.2020.v08i11.004
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Introduction: Community acquired pneumonia (CAP) is defined clinically as presence of signs and symptoms of pneumonia in a previously healthy child due to an infection which has been acquired outside hospital. Pneumonia is the leading cause of death in children worldwide. Accurate assessment of severity and prognosis is important to decide management of pneumonia. Objective: The objective of present study is to study role of Chest X-ray in predicting severity of pneumonia in children. Material & Methods: This was prospective observational type, hospital based study conducted from March 2019 till June 2020 years in Dept. of Radiology & Imaging Pediatric ward of Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh. A total of 307 children aged 3 months to 59 months diagnosed with Pneumonia & Severe pneumonia as per World Health Organization (WHO) criteria were included in study. Chest radiographs were reported by Pediatric Radiologist and findings classified as Normal, Primary End point consolidation, Other Infiltrates, Pleural effusion. Results were compared in sub-group i.e. Pneumonia & Severe Pneumonia. Results: Hypoxia, cyanosis, grunting and severe malnutrition were found to be poor predictors of radiographic pneumonia. Bilateral infiltrates (30%) & Primary end point consolidation on right side (17%) are independent determinant of severity of pneumonia. Bilateral consolidation and bilateral pleural effusion on chest X-ray are associated with poor outcome. Conclusion: Children with cyanosis, grunting, hypoxia & severe malnutrition should preferentially have chest X-ray done since they are more likely to have consolidation, infiltrates or pleural effusion. Children with Bilateral infiltrates, Consolidation and Bilateral pleural effusion should preferably be admitted to pediatric intensive care unit for more aggressive monitoring and management, since they have poor outcome.
Original Research Article
Nov. 6, 2020
Role of Multidetector Computed Tomography in Diagnosis and Evaluation of Pancreatic Lesions
Dr. Anmol Singh, Dr. V. M. Kulkarni
Sch J App Med Sci | 2456-2466
DOI : 10.36347/sjams.2020.v08i11.005
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Computed tomography (CT) is one the primary imaging modalities for evaluating the pancreas along with ultrasound. This is a prospective observation study assessing the role of multidetector computed tomography in pancreatic lesions. The study was performed at Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri on Philips Ingenuity Core 128 slice CT machine. A total of hundred cases were studied. Pancreatic disorders on average were more common in males than in females. The commonest age bracket affected was between 30 – 49 years. The most common pancreatic lesion was acute pancreatitis followed by chronic pancreatitis and pancreatic carcinoma. Computed tomography is a sensitive and efficacious modality for detection and characterization of pancreatic lesions. Pancreatic parenchymal phase was useful in identifying necrotic areas in necrotizing pancreatitis and neoplastic encasement. Portal venous phase was useful in detecting vascular thrombosis and hypovascular metastasis in the liver.
Original Research Article
Nov. 9, 2020
Pattern of Fluid and Electrolyte Imbalance in Early Postoperative Period Following Temporary Ileostomy
Dr. ASM Rezbanul Haque, Dr. Md. Forhad Hossain, Dr. Md. Firoz Mia, Dr. Ismat Ara, Dr. Samina Tasnim, Dr. Md. Anisur Rahman, Dr. Md. Mahfuzul Haque, Dr. Bablu Kumar Saha
Sch J App Med Sci | 2467-2471
DOI : 10.36347/sjams.2020.v08i11.006
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Background: There are complications of ileostomy development, including fluid and electrolyte imbalance. Although predictors of high morbidity have been established by studies, readmission rates remain high. Objective: In this study, our main goal is to evaluate the patter of fluid and electrolyte imbalance in the early postoperative period of a temporary ileostomy. Method: This retrospective study was conducted at a tertiary medical college and hospital from January 2017 to December 2019. A total of 120 patients with ileostomy creation, were included in this study. We obtained the medical records and compiled data of the patients admitted to the hospital. Results: In this study, 60% of patients were male and 40% were female. Maximum (40%) patients were between 40-49 years of age group. Among 120 patients, 49 were readmitted due to fluid and electrolyte abnormalities and 27 were readmitted due to other diagnoses. Only the use of antidiarrheals and neoadjuvant therapy remained important after multivariate review. Conclusion: Our study concluded that the use of a patient should be carefully checked at home postoperatively. Our study also recommends the thought of shirking of ileostomy creation or diverse release standards for patients at risk. Postoperative findings showed that stoma checking after release may help decrease rehospitalizations for liquid and electrolyte anomalies after ileostomy creation. Antidiarrheals might be a marker for patients in danger for patter fluid and electrolyte imbalance.
Original Research Article
Nov. 11, 2020
Histopathological and Clinical Correlation of Hyperpigmented Skin Lesions
Dr. Sneha Ravindran, Dr. Kalla Ravi Teja, Dr. Arun Kumar SP, Dr. Jonathan Arnold, Dr. Balaji S
Sch J App Med Sci | 2472-2477
DOI : 10.36347/sjams.2020.v08i11.007
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Introduction: The spectrum of clinical disease related to hyperpigmented lesion is wider. The most common hyperpigmented skin lesion is lichen planus and its variants. Histopathological examination helps to derive an accurate tissue reaction. Pathologic examination often serves as a confirmative diagnosis for skin lesions. The histology-based treatment will be helpful for establishing a standardized management for hyperpigmentary skin lesions. Materials and Methods: A total of 100 patients with hyperpigmented punch skin biopsy lesions in all age groups following inclusion and exclusion criteria is taken and examined for histopathological correlation from the Department of Pathology. Result: In this study of hyperpigmented skin lesions the maximum number of cases 45 (45%) were those of classical Lichen planus and its variants, followed by 12% of eczematoid dermatitis, 8% of PMLE, 7%of DLE, 6% of lichen simplex chronicus, 7% of post inflammatory hyperpigmentation, 3% of prurigo nodularis, 4% of prurigo simplex, morphea 4%, acne 3%, and 1% of erythema dyschromium perstans. 90% cases show histopathological correlation and 10% cases were diagnosed only on histology based. Conclusion: Lichen planus and its variants are most common hyperpigmentary skin lesions found in the study population. The pathologist ability to render an accurate diagnosis depends on the available clinical evaluation details.
Original Research Article
Nov. 11, 2020
Prevalence of Pediculosis Capitis and Associated Factors among Primary School Children at Kawiley Village North Sulawesi, Indonesia
Herlina Wungouw, Ventje Memah, Christine Salaki, Dantje Tarore, Ronald Ottay, Vanda D. Doda , Irene Rumampuk, Hizkia Rumampuk
Sch J App Med Sci | 2478-2482
DOI : 10.36347/sjams.2020.v08i11.008
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The prevalence of pediculosis capitis is still high worldwide regardless of the many attempts to eliminate the cause either in developed or developing countries. Many factors contribute to the difficulties to eradicate this problem, one being the efficiency of the mite to breed and spread undetected. Children, who are affected, are mostly in their primary school period, may experience anemia, sleeping disturbances, wound in the scalp, negative social stigma, and problem in concentration and learning. Mother, as a primary caregiver for children in a conventional or domesticated society, may take part in the development and spread of pediculosis capitis in these children. This study explores the prevalence of pediculosis capitis in a rural area in Indonesia and its association to gender, mothers’ level of education. Method: This study is a cross sectional study that depicts and analyze the prevalence of pediculosis capitis and its associated factors at one primary school in Kawiley village North Sulawesi. Samples who met the criteria and used in this study are 83 primary school children. They were recruited randomly from primary school. Participants consist of 48 Girls and 35 Boys were brought in and examined for pediculus capitis infestation. Mothers’ educational level were gained from school database. Results and Discussion: The prevalence of pediculosis capitis was 68.7% (57 students), in which 39 out of 48 girls had pediculosis capitis (81%) in contrast to the 18 (51%) out of 35 pediculosis capitis in boys. Statistically, using Chi Squares tests, the prevalence of pediculosis capitis is associated with gender (p 0.04). Meaning that Girls, like many publications sugested, still have higher presentation for head louse infestation than boys. Several factors are suggested to contribute for this prevalence including the length of girls’ hair and using the same combs, bandana, towel, and other stuff together. Regarding mothers’ education level, there is no .............
Review: The Impact of Covid-19 and Possible Mechanisms on Prevention of Suicidal Ideations
Cho Cho Zaw Raheema, Myat Min Mohd Omar
Sch J App Med Sci | 2483-2489
DOI : 10.36347/sjams.2020.v08i11.009
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Covid-19 known as the ‘2019 Novel Coronavirus (2019-nCoV) Pneumonia’ is believed to spread from Wuhan, China, then aroused the global attention due to its fast spread nature throughout the World. In March 2020, World Health Organization (WHO) declared Covid-19 as a global pandemic. Covid-19 causes a tremendous impact to people throughout the world by affecting their physical, mental, social, and financial aspects of their life. Many studies have been pointed out the relationship between stress and suicide, and it is noted that Covid-19 also relates psychological problems among people by making them anxious, stress and worries. Thus, this study is intended to explore the impact of Covid-19, and its relationship with suicidal ideation, and the possible mechanisms to prevent it. The qualitative study by literature review method was used as a methodology. The findings were categorized into two major themes: (i) the impact of Covid-19 and its relationship with suicidal ideation, in which three sub-themes were identified as economic, social, and psychological; and (ii) the possible mechanisms for prevention of suicidal ideation, in which four sub-themes were identified as ‘guidelines on suicide prevention and emergency crisis’, ‘raising awareness regards to suicidal ideation and attempts’, ‘online mental health services for suicide prevention’ and ‘limitation of watching news and social media’. The discussions were made based on the identified information such as the impact of Covid-19, mental health issues and suicidal ideation, preventive measures against suicide including health education, community awareness, online mental health services, government guidelines in preventing suicide, and the national support. The need for further research by using different methodologies was recommended. It is hoped that this paper serves as a source of information for public awareness on suicidal ideation and possible mechanisms to prevent it.
Knee Dislocation Complicated by A Vascular-Nervous Injury: Case Report and Review of the Literature
Mohamed Rida El Galiou, M. Boufettal, R. A. Bassir, M. Kharmaz, M. O. Lamrani, M. S. Berrada
Sch J App Med Sci | 2490-2492
DOI : 10.36347/sjams.2020.v08i11.010
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Pure knee dislocations are rare injuries .Vascular-nervous complications must be explored systematically. The authors report the case of a 58 years old patient, who presented to the ER with a traumatic knee dislocation associated to a paralysis of the external popliteal sciatic nerve and an occlusion of the popliteal artery. The patient benefited from a reduction, a femoro-tibial stabilization by an external fixator bridging the knee and a bypass of the popliteal artery using a graft from the saphenous vein intern.
Original Research Article
Nov. 9, 2020
Study of Clinicobacteriological Profile of Neonatal Sepsis Patients Admitted In Tertiary Care Hospital in Telangana
Dr. Pooja Palla, Dr. M. Alimelu
Sch J App Med Sci | 2493-2496
DOI : 10.36347/sjams.2020.v08i11.011
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Background: Septicemia in new born is of major public health concern, though recent medical advances have improved neonatal care, there are still many challenges remaining in the diagnosis and management of neonatal infection. Immature immune system and invasive life support make the premature neonates susceptible to infections. The diagnosis is complicated especially by the presence of noninfectious conditions. Objective: To study the Clinical and Bacteriological profile and antibiotic susceptibility pattern of septicemic neonates in the microbiology department, Niloufer hospital and find the significant risk factors leading to cause septicemia. Methods: Retrospective study was carried out in the Department of Microbiology at Niloufer Hospital, Red hills between January 2019 to Nov 2019.737 clinically suspected samples were included in the study, were processed. Identification and antibiogram of the isolates were done as per standard procedures. Clinical symptoms, Laboratory Parameters, Risk factors were statistical analysed, pvalue < 0.05 was considered significant. Results: Among 737 samples, 135 isolates identified and grouped.Gram positive organism 98 (72%) out of which Coagulase Negative Staphylococcus 93(68.9%). CoNS causing Proven Sepsis were 66 (48.9%). Among Gram Negative Organism Klebsiella pneumonia (48.6%) was commonest. Elevated CRP levels was significant to categorise CoNS isolate. Neutropenia and Thrombocytopeniawere significant in Gram negative sepsis. All the clinical symptoms and Risk factors were significant. Conclusion: Low birth weight and premature neonates are the greatest risk factors for the neonatal sepsis. Immature host defense mechanism and prolong use of CentralVenous catheters, mechanical ventilation, parenteral nutrition has led to the increase risk of CoNS infection in Late onset sepsis.By updating the Antibiotic policy can decrease the usage of Catheters and early shifting to enteral feeding can decrease the chance of late onset....
Original Research Article
Nov. 13, 2020
Barriers in Utilization of Reproductive and Child Health Services in Slums of Delhi, India: an Observational Study
Dr. Anand Kumar Verma, Dr. Prakash Ranjan, Dr. Rabi Bhushan, Dr. V. K. Tiwari
Sch J App Med Sci | 2497-2503
DOI : 10.36347/sjams.2020.v08i11.012
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Background: The utilization of Reproductive and Child health (RCH) services is often influenced by the socio-cultural, financial, access, political barriers acting at the community, family and individual level. Aim and objective: To examine the barriers in utilization of RCH services in slums. Material & Methods: The study was carried out in three slums of Delhi with a well representative sample of 421 women, who delivered the child within 6 months. Quantitative and qualitative study design was followed to collect the data. Results: The supply side barriers such as physical access and facilities were faced by the service providers. The demand side barriers such as socio-cultural, financial and access barriers were faced by the service receivers in order to avail the services. Conclusions and Recommendation: In order to overcome the barriers faced by the women of slums, it is important to improve the access to services so that they get them easily. Some of the imperative actions such as strengthening community mobilization through inter-personal communication, dialogue with the key influencers in the community as well as continuous engagement with and sensitization of the service providers.
Original Research Article
Nov. 13, 2020
Study of Pleural Effusion Cytology in Neoplastic and Non-Neoplastic Conditions in Correlation with Adenosine Deaminase Levels
B. Vamsi Krishna, S. Srikanth
Sch J App Med Sci | 2504-2507
DOI : 10.36347/sjams.2020.v08i11.013
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Introduction: The term serous effusion refers to the fluid collected in the three serous cavities namely pleural, peritoneal and pericardial. Serous effusions form an important source of useful diagnostic information in clinical practice. Pleural effusion cytology is the simplest definitive method available to diagnose the disease, which are the causes of pleural effusion. Diagnostic cytology depends on the fact that cells exfoliated or collected from a tissue surface reflect changes occurring in the underlying tissue. Materials & Methods: This study was conducted for a period of two years. The study was prospective based on cases admitted as in-patients. Total 235 cases were taken, and the ages of patients ranged from 14 years to 70 years and the group consisted of 170 male patients and 65 female patients. Results: Out of the total 235 patients with pleural effusion 196 were non-malignant and 39 were malignant. Out of the 235 effusion samples the majority were of non-specific compromising 47%. Next common was specific inflammation effusion comprising 33% next was malignant effusion comprising 17%. The unconfirmed effusion 3% were at the end of work up remained in conclusive. Conclusion: The present study demonstrated that the most useful single test in establishing the diagnosis of pleural effusion is the pleural fluid cytological study (60%). In conclusion, an ADA level of pleural fluid is a non-invasive, inexpensive and repeatable test that provides the results quickly. This study indicates that the ADA levels of the pleural fluid can be used with high diagnostic rates in the diagnosis and exclusion of the tuberculosis in patients whom the pleural tissue could not be obtained with various causes in the differential diagnosis of Tuberculosis and Malignant effusions, and those with waiting for the laboratory outcomes of the pleural tissue. In non-biopsy based Tuberculosis diagnosis a threshold of 47 IU/dl is most useful.
Original Research Article
Nov. 13, 2020
A Good Lifestyle to Avoid Cardiovascular Disease
Dr. Muhammad Alnawa, Dr. Mohamad Alfarouh
Sch J App Med Sci | 2508-2514
DOI : 10.36347/sjams.2020.v08i11.014
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Background: Healthy lifestyle can avoid several problems related to our health and can also avoid several known diseases such as Cardiovascular diseases. In order to adopt a healthy lifestyle we need to adopt healthy habits such as eating a customized diet as per your daily routine and health, exercising regularly depending on the body weight goals to keep your body fit with minimal fat, and avoid eating food that contain high cholesterol such as beef, and quit smoking which would remarkably minimize the chance of cardiovascular diseases by managing and regulating the cholesterol levels, blood pressure, and other predisposing factors. Limited data are available about the consequences of multiple lifestyle factors that directly or indirectly affects the cardiovascular diseases. Method: We have considered the study to check the impact of change in lifestyle of those having cardiovascular disease and those who have never suffered with such diseases. The data were analyzed to associate CVD patients with corresponding normal individuals. Patient pairing was accomplished on one to one ground with reference to their age, sex, education and economic status. There was a total trial size of 162. A survey questionnaire system was prepared to understand lifestyle behavior, including questions on health habits, work engagement, locus of control. The recording of their reaction was analyzed. The higher the ratings, the more the unhealthy lifestyle is, while the balanced lifestyle is designated by low scores. We carried out qualitative and quantitative assessments. The hypothesis originated was that “"Patients of cardiovascular diseases (CVD) will have a higher lifestyle score relative to matched non-CVD individuals”.
Original Research Article
Nov. 14, 2020
A Comparison between Dissection and Diathemy Tonsillectomy: Study in a Secondary Care Hospital, Sirajgonj, Bangladesh
Dr. Md. Shafiul Islam, Dr. Joynal Abedin, Dr. Waliul Hasnat, Dr. Abu Rayhan Bhuyan
Sch J App Med Sci | 2515-2519
DOI : 10.36347/sjams.2020.v08i11.015
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Background: Basically tonsillitis is rapid onset inflammation of the tonsils. It is associated with sore throat, fever, enlargement of the tonsils, troublesome swallowing and large lymph nodes around the neck. Dissection versus diathermy tonsillectomy is two reliable methods in the treatment of tonsillitis. We have a few comparative information between those two different methods. Aim of the study: The aim of this study was to evaluate the dissection and diathemy tonsillectomy in treating the patients with tonsillitis. Methods: This prospective cross sectional study was conducted in the Department of Otolaryngology & Head-Neck Surgery, Sirajganj 250 Bed Bongamata Sheikh Fazilatunnesa Mujib General Hospital, Sirajganj, Bangladesh during the period from January 2018 to December 2019. In total 125 patients of several ages with tonsillitis required dissection or diathemy tonsillectomy were finalized as the total study population. Among total participants in Group I, in 48 patient’s diathemy method was applied whereas in Group II in 77 patients dissection procedure was applied. All the data were collected, processed and disseminated by using SPSS version 15.5. Result: In both the groups the mean hospital staying duration was the same and it was 1 day (SD: ± 0.22). Among both the groups in 9 (18.75%) participants of Group I got any type of post-operative complication whereas it was in 26 (33.77%) participants of Group II. In this study per-operative blood loss for diathermy tonsillectomies ranged from 8 ml to 30 ml, with the average being 15 ml. On the other hand, per-operative blood loss for dissection method of tonsillectomy ranged from 30 to 80 ml, with the average being 45 ml. In dissection-method, needed average time was 16.75 minutes whereas in diathermy procedures it was 24.50 minutes. Conclusion: In both the procedures post-operative bleeding, pain, fever and infections were the common complications. But difference of the volume of intra-operative..............
Original Research Article
Nov. 14, 2020
Punch Rectal Biopsy in Diagnosis of Hirschsprung’s Disease - An Updated Study
Md. Abdus Sattar, Md. Mahfuzul Haque, Arun Kanti Paul, Md. Ruhul Quddus
Sch J App Med Sci | 2520-2523
DOI : 10.36347/sjams.2020.v08i11.016
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Background: Hirschsprung's disease is a common cause of neonatal & infantile intestinal obstruction. The accurate diagnosis of HD depends on histopathological demonstration of the complete absence of ganglion cells with the presence of hypertrophied nerve fibers in the distal bowel. So, rectal biopsy is the gold standard way for diagnosis of HD. Aim of the study: This study is an attempt to find out a simple, safe, sensitive, less time consuming, cost effective with accurate histopathological results for diagnosis of HD, specially for poor and developing countries of the world. Methods: This was a cross sectional, prospective study, purposive sampling was done. Total 25 patients of suspected Hirschsprung’s disease were included in this study after fulfillment of inclusion criteria from November 2010 to March 2012 at Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh. Result: Out of 25 cases, 17 were diagnosed as having HD, 8 were diagnosed as having no HD. The sensitivity was 80% and positive predictive value was 94.11% of punch rectal biopsy. Operation time was only 14 minutes (on average). Cost was very less 1850 taka (on average). Post procedure hemorrhage occurred only in 1 cas, No perforation occurred among all cases. Conclusion: Punch rectal biopsy for diagnosis of HD is an advantageous method in the form of less time, less cost, less complication with efficacious.
Original Research Article
Nov. 14, 2020
Postoperative Findings of Nausea and Vomiting: Study in a Private Clinics, Dhaka, Bangladesh
Dr. Mohammad Mostafizur Rahman, Dr. Jannatul Ferdous
Sch J App Med Sci | 2524-2528
DOI : 10.36347/sjams.2020.v08i11.017
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Introduction: Post-operative Nausea and Vomiting still remains a challenge, despite having clinical perception and evidence that its severity has diminished. We conducted a descriptive study in post the operative units in several private clinics, Pabna, Bangladesh. Aim of the study: Our aim was to find out the magnitude of postoperative nausea and vomiting in patients. Material & Methods: This was a prospective descriptive study to estimate the incidence of postoperative nausea and vomiting. We conducted this study in post-operative units in the Department of Anesthesia, Ashiyan Medical College Hospital, Barua Khilkhet, Dhaka, Bangladesh Dhaka, and Bangladesh during the period from January 2018 to December 2018. Results: Nausea, emetic episodes and the need for anti-emetic medication were recorded for 24 h postoperatively. In the post-operative unit, nausea and vomiting were 27.25% and 13.25%, respectively. Over the whole 24-h period, these figures were 65.75% and 35%, respectively and severe nausea was experienced by 7.88% in an average. The highest rate of emetic sequelae was observed in gynaecological patients; 42% of the patients who received general anaesthesia and 62% of the patients who received regional anaesthesia reported nausea. Conclusion: The most important predictive factors associated with an increased risk for nausea and vomiting were female gender, a previous history of postoperative sickness, a longer duration of surgery and a history of motion sickness. Even though, nausea and vomiting problem is neglected in developing world like Bangladesh but it’s indeed a big problem for the patients and can hindered normal treatment procedures. Researchers should give more attention to this issue for reducing the burden of treatment facilities in our country.
Original Research Article
Nov. 14, 2020
Spinal Anaesthesia and General Anaesthesia for Laparoscopic Cholecystectomy: Study in a Private Hospital, Dhaka, Bangladesh
Dr. Mohammad Mostafizur Rahman, Dr. Jannatul Ferdous
Sch J App Med Sci | 2529-2533
DOI : 10.36347/sjams.2020.v08i11.018
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Introduction: Laparoscopic cholecystectomy is an insignificantly offensive surgical procedure for the elimination of a diseased gallbladder. LC has become the gold standard for the surgical treatment of symptomatic cholelithiasis and has gained worldwide acceptance. It is a negligibly invasive procedure with a considerably shorter hospital stay and a earlier recovery compared with the classical open cholecystectomy. Aim of the study: The aim of our study was to compare between Spinal Anaesthesia and General Anaesthesia for laparoscopic cholecystectomy in healthy patients. Material & Methods: This comparative clinical study was conducted in the Department of Anesthesia, Ashiyan Medical College Hospital, Barua Khilkhet, Dhaka, Bangladesh during the period from January 2017 to December 2017. The aim of our study was to compare between Spinal Anaesthesia and General Anaesthesia for laparoscopic cholecystectomy in healthy patients. A total of 120 patients aged between 18-65 years of both sex with ASA Grade status I and II undergoing elective laparoscopic Cholecystectomy were selected for the study. After taking written informed consent from the study participants, we were elected 120 study subjects and divided into two groups; Group I (n=60) received General Anaesthesia. And Group II (n=60) received Spinal Anaesthesia. Elective laparoscopic Cholecystectomy procedure was taken. Results: In this study majority patients (70% and 63% in Group I and Group II respectively) were male and mean age was 36.67 in Group I, 34.58 in Group II. Mean operative time (minutes) were 66.03 in Group I, 66.63 in Group II. Average hospital stay was 48.33 hours in Group I and 36.53 hours in Group II. Conclusion: Spinal Anaesthesia was observed to be better safety and sufficiency in patients of good health in the present study.
Original Research Article
Nov. 14, 2020
A Comparison of Serum Bilirubin, CTP and Meld Score in Patients with HBV-ACLF
Dr. Sharker Mohammad Shahadat Hossain, Professor Dr. Mamun Al Mahtab (Shwapnil), Professor Salimur Rahman
Sch J App Med Sci | 2534-2540
DOI : 10.36347/sjams.2020.v08i11.019
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Background: Billirubin is a yellowish substance in blood. It forms after red blood cells break down, and it travels through your blood. It forms after red blood cells break down, and it travels through your liver, gallbladder and digestive tract before being excreted. Typically, billirubin levels fall somewhere between 0.3 and 1.2 milligrams per deciliter (mg/dl). A billirubin test measures the amount of billirubin in your blood. It’s used to help find the cause of health condition like jaundice, anemia and liver disease. Bilirubin is an orange-yellow pigment that occurs normally when part of your red blood cells break down. The liver, however, is able to replace damaged tissue with new cells. If up to 50 to 60 percent of the liver cells may be killed within three to four days in an extreme case like Tylenol overdose, the liver will repair completely after 30 days if no complications arise. Child-Turcotte-Pugh (CTP), model for end stage liver disease (MELD) and MELD sodium (MELD-Na) scores are used for predicting disease severity and mortality among patients with end-stage liver disease. If MELD score is under 10: It will be recalculated once a year: 11-18: It will be recalculated every 3 months. 19-24: It will be recalculated once a month. 25 or higher: It will be recalculated every week. Aims: The goal to see the comparison of serum bilirubin, CTP and Meld score in patients with HBV-ACLF. Methodology: In this study a total of 32 acute on chronic Hepatitis B liver failure patients (age > 18 years with both sexes but male predominant) were included in Hepatology department of Bangabandhu Sheikh Mujib Medical University, Dhaka during January 2013 to December 2015. The patients were randomized into two groups: Tenofovir group (N=16) and Entecavir group (N=16) and followed at least for 03 months. Result: The total study population was 32 patients 16 (50.00%) males and 16 (50.00%) females. Table-1 demonstrted the characteristics of patients with serum bilirubin, .......
Original Research Article
Nov. 16, 2020
Benign Tumors of the Maxillary Bones (About 30 Cases)
Othmane Bouanani, Bouchra Dani, Salma Benazzou, Malik Boulaadas
Sch J App Med Sci | 2541-2544
DOI : 10.36347/sjams.2020.v08i11.020
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Introduction: Benign neoplasms of the maxillary include various histological entities. In the vast majority of cases, these tumours are related to elements of the dental system and are referred to as odontogenic tumours. More rarely, they are bone tumors themselves, then called non-odontogenic tumors. Materials and Methods: Our study is a retrospective study of 30 cases of benign neoplasms of the maxillary, collided within the maxillofacial surgery department of the Specialty Hospital-Rabat, between January 2014 and February 2018. Results: Data analysis found a frequency of odontogenic tumours that represented 67% versus 33% of non-odontogenic tumours. The average age was 24 years with no gender predominance. The consultation period was 3 years. Facial swelling was the master symptom, sometimes associated with dental signs in 35% of cases. All our patients received a radiological check-up. Treatment was conservative in 75% of cases. The confirmation of the diagnosis was always based on the anatomopathological examination of the surgical removal part. The evolution was generally favourable in 70% of our patients, without recurrence. Discussion: Benign neoplasms of the maxillary have a wide range of histological features and can be divided into 2 major groups: odontogenic and non-odontogenic tumours. Despite their great diversity, the clinical description of these tumors is unambiguous, and it is often the radiological record that will allow to evoke the diagnosis whose confirmation is indispensable by the anatomopathological examination; surgical treatment is usually conservative with good postoperative evolution.
Rare Intraparotid Localization of Kimura’s Disease (A Case Report and Literature Review)
Othmane Bouanani, Alain Habimana, Salma Benazzou, Malik Boulaadas
Sch J App Med Sci | 2548-2550
DOI : 10.36347/sjams.2020.v08i11.022
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Introduction: Kimura’s disease is a very rare chronic inflammatory pathology of unknown etiology. It is actually an allergic or autoimmune reaction process involving blood vessels, lymphocytes and eosinophils. Observation: We report a case of Kimura disease with cervical localization in a 37-year-old Patient who saw the appearance of a swelling of the right parotid region evolving for 1 year. The patient benefited from a total right parotidectomy with homolateral selective curage and the anatomopathological study of the tumoral piece came back in favor of Kimura’s disease. The evolution was good. The regression is one year without recurrence. Discussion: Kimura’s disease is characterized clinically by subcutaneous nodules of cervicofacial localization, increased volume of salivary glands and satellite adenopathies. Its diagnosis is histological based on the identification of follicular hyperplasia with eosinophilic polynuclear abscesses. Treatment is surgical most often but in some cases corticotherapy is proposed.
Rare Lymph Node Localization of Whartin Tumor (A Case Report and Literature Review)
Othmane Bouanani, Rajae El Azzouzi, Salma Benazzou, Malik Boulaadas
Sch J App Med Sci | 2551-2552
DOI : 10.36347/sjams.2020.v08i11.023
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Introduction: Warthin’s tumor, otherwise known as papillary cystadenolymphoma, is a benign epithelial tumor of the salivary glands. It has characteristic oncocytic glandular structures and lymphoid stroma. It is found almost exclusively in the parotid gland and periparotid lymph nodes. Observation: We report the case of a 50-year-old patient who consulted for a bilateral parotid cervical swelling that had been evolving for 6 years, painless, superficially mobile, without any notion of facial paralysis and without inflammatory signs. The patient received cervicofacial CT with a well-limited bilateral parotid mass with a separation border with parotid parenchyma. Treatment consisted of a cervical surgical removal of the 2 masses whose histological examination returned in favour of a lymph node localized whartin tumor. Discussion: The whartin tumor is a benign tumor with mainly parotid development, nevertheless periparotid ganglionic involvement is relatively rare but possible. The reference radiological exam is cervicoparotidian MRI and the treatment is surgical.
Original Research Article
Nov. 18, 2020
Evaluation of Smoking as a Predominant risk factor in Coronary Artery Disease: A Case Control Study
Dr. Venkata Subbarao. M, Satyendra Kumar. A
Sch J App Med Sci | 2553-2555
DOI : 10.36347/sjams.2020.v08i11.024
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Introduction: Smoking remains the number one cause of preventable morbidity and mortality. A leading cause of death attributable
to smoking is Cardiovascular disease (CVD). Most common presentation of Coronary artery disease (CAD) is myocardial infarction
and angina pectorals. Cigarette smoking also contributes to CVD in a number of ways. Materials and Methods: A Case Control
Study was conducted in Tertiary care teaching center and Hospital over a period of 6 months. Patients admitted in the Medical ward
who are willing to participate in this study were enrolled in this study. Results: In our study, both the groups consisted of 100
subjects each. While comparing between Smoker and non-smoker mean age was not statistically significant by using unpaired t-test
(p-value 0.36). While comparing between Smoker and non-smoker group in hypertensive was statistically significant difference by
using Chi-square test (p=0.025). While comparing between Smoker and non-smoker group, with more than 50% stenosis, with or
without co-morbidities. While comparing between Smoker and non-smoker group in co-morbidities was statistically highly
significant difference by using Chi-square test (p=0.0001). Whereas, comparing between Smoker and non-smoker group in without
co-morbidities was statistically highly significant difference by using Chi-square test (p=0.0001). Conclusion: In our study that
both the case and control groups shows in both group smokers and non-smokers have CAD but higher in smokers group then in
non-smokers and data was statistically insignificant between case and control group.
Original Research Article
Nov. 19, 2020
Evaluation of Short Term Outcome of Acute Ischemic Stroke by Modified Rankin Scale
Dr. Priobrata Karmakar, Dr. Sukumar Majumder, Dr. Monika Roy, Dr. Sushanta Kumar Barman, Dr. Asm Shafiujjaman, Dr. Md. Ruhul Amin Sarkar
Sch J App Med Sci | 2556-2561
DOI : 10.36347/sjams.2020.v08i11.025
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Background: Stroke is the most common cause of morbidity and mortality worldwide. There are two types of stroke, ischaemic stroke and haemorrhagic stroke. The most important diagnostic tool of acute stroke is CT scan of brain. In acute ischaemic stroke, there are diverse CT scan findings especially in respect of anatomic location of ischaemic change or character. After the event of acute ischaemic stroke the patient may become completely stable or may develop complications or may die within a few days. Objective: This study is designed to access short term outcome of Modified Rankin Scale of acute ischaemic stroke. Methodology: This is a prospective observational study done in Rangpur Medical College Hospital during the period of July, 2015 to June, 2017. Total 60 cases were enrolled from the admitted patients in Medicine and Neuromedicine department of Rangpur Medical College Hospital, in this study by purposive consecutive sampling technique fulfilling the inclusion and exclusion criteria. CT scan of brain was done for each patient after taking informed consent. Radiological evidence of acute ischaemic stroke was ascertained by radiologist. Data were collected from each patient and/or attendants by taking meticulous history, clinical examination and relevant investigations. Clinical status and afterwards outcome after 7 days of admission was measured by Modified Rankin Scale. All data were collected in individual predetermined case record form and analysed by SPSS version 17.0. Results: Total number of patients was 60. Male female ratio was 1.2:1. During study period 22% (N=13) died out of 60 patients. Thirty six(60%) patients had infarction due to proximal occlusion of artery mostly middle cerebral artery and 24(40%) patients had lacunar infarcts.Morbidity was measured by modified Rankin scale at the time of admission and during follow up after 7 days. Morbidity was found to be significantly increased in proximal occlusion stroke than lcunar sroke (P value....
Original Research Article
Nov. 20, 2020
CD4 and CD8 Count in Breast Cancer Patient Undergoing Post-Surgery FAC Protocol
Dr. Abdullah Al Mueed Khan, Dr. Jobaida Naznin, Dr. Shantanu Das, Prof. Dr. Osul Ahmed Chowdhury
Sch J App Med Sci | 2562-2565
DOI : 10.36347/sjams.2020.v08i11.026
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Objective: In this study our main goal is to evaluate the CD4 and CD8 count in breast cancer patient undergoing post-Surgery FAC protocol. Method: This quasi-experimental study was carried out at Dept. of Microbiology, Department of radiotherapy & Department of Surgery, Sylhet MAG Osmani Medical College Hospital from January, 01, 2011 to December, 31, 2011. Samples from the 30 cases were collected, first from Department of surgery (before operative procedure) and then, from Department of radiotherapy (after surgery and 3 cycles of adjuvant chemotherapy) from the same patient. Results: During the study, left breast was involved in 17 (53.3%) patients and right breast was involved in 13 (43.3%) patients. Regarding histological grading was grade-II in 13 (43.3%) cases, grade-I in 11 (37.7%) and grade-III in 6 (20.0%) cases.CD4+T cell count before chemotherapy was 1023.4 /uL (SD ± 320.7) and CD4+T cell count after chemotherapy was 540.7 /uL (SD ± 266.1). CD4+T cell count was significantly reduced after chemotherapy (z=9.164; p<0.001). Conclusion: from our study we conclude that, CD4 and CD8+ T cell number and their ratio as an assessment of immune function status in breast cancer patients, before and after surgery and adjuvant chemotherapy with the intention of delineating any potential immune aberrations that may result from therapy.
Original Research Article
Nov. 21, 2020
Ultrasonographic Evaluation of Diseases of Hepato-biliary System in the Northern Part of Bangladesh
Md. Murshed Ali
Sch J App Med Sci | 2566-2568
DOI : 10.36347/sjams.2020.v08i11.027
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Introduction: Disease of gall bladder and liver are still a major problem in Bangladesh as well as in the whole World. Neoplasm of gall bladder, biliary ascariasis is more common in this region. This study was performed to evaluate the diseases of hepato-biliary system in patients attending in the Institute Nuclear Medicine and Allied Sciences, Rangpur. Methods: This retrospective study was conducted in the Centre for Nuclear Medicine and Ultrasound of Rangpur Medical College Hospital, Rangpur Bangladesh during the period from September 2017 to February 2019. A total of 1203 (M=578 F=625) patients aged from 20 years to 70 years were included in this study. Statistical data were analysed by using MS-Excel 2016. Result: A total of 1203 (M=578 F=625) patients aged from 20 years to 70 years were included in this study. In this study about 389 (32.33%) patients were having different diseases of liver and gall bladder, among them 216 were female and 173 were male. A total of 198 patients had cholelithiasis (16.45%). Conclusion: From this study it can be concluded that, the valuable information obtained by proper ultrasound can reduce unnecessary delay in management of diseases, thereby relieving the patient from many morbid conditions.
Radionuclide Synovectomy in Inflammatory Arthritis –Prospect in Bangladesh, Scientific Review
Md. Murshed Ali
Sch J App Med Sci | 2569-2572
DOI : 10.36347/sjams.2020.v08i11.028
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Radionuclide synovectomy is an attractive alternative to surgical synovectomy for the management of the various joint diseases. Recently, the development of new radiopharmaceuticals labeled with 90Y, 32P, 186Re, 188Re, 153Sm, 165Dy and 166Ho, for the effective management of synovial inflammation and related arthritic pain is gaining attention. The background and mechanism, radiopharmaceuticals and injection methods, clinical applications and results, patient’s selection, assessment of efficacy, and complications and contraindications of radionuclide synovectomy are reviewed.
Original Research Article
Nov. 23, 2020
Echocardiographic and Angiographic Profile of Patients with Lateral Wall Mi Ecg Presentation in Inferior Wall Mi (A Comparison Study)
Sibaram Panda, Sunil Kumar Sharma
Sch J App Med Sci | 2573-2577
DOI : 10.36347/sjams.2020.v08i11.029
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Background: Patient with lateral wall changes in inferior wall MI usually ignored most often. Patients with inferolateral MI show very diverse clinical presentations as compared to inferior wall MI without lateral MI ECG changes of inferolateral MI in comparison to inferior wall MI without lateral wall ECG changes. Materials and methods: This study enrolled 405 patients admitted to cardiology emergency with inferior wall MI. Patients divided into three groups on the basis of ECG changes, A) inferolateral B) isolated inferior wall MI MI C) inferior wall MI with RVMI. Patients with RVMI (group C) excluded from the group. Electrocardiographic, echocardiographic, angiographic outcomes compared between group A and B. Results: More than1/3 rd patient with inferior wall MI have associated lateral wall changes. STEMI equivalent changes in anterior leads noted in around 2/3 rd patients. LV dysfunction seen in around 47.5% of the patient of inferolateral wall MI, which is significantly higher in comparison to 9% patients in inferior wall MI .Culprit lesion in inferolateral MI most often found to be left circumflex coronary artery. Multivessel lesion in inferolateral MI in 36.8% patients, which is significantly higher as compared to inferior wall MI without lateral wall ECG changes (i.e.11.4 % patient). Conclusion: Patient with infererolateral MI have grave prognosis due to higher incidence of LV dysfunction, multivessel involvement and mitral regurgitation.Culprit lesion is most often left circumflex artery. So meticulous attention should be given to patients with lateral wall MI changes in inferior wall MI for better treatment strategy.
Original Research Article
Nov. 23, 2020
Efficacy of Occlusion Therapy for Management of Amblyopia in Children age Older than Six Years
Dr. Sonalee Mittal, Dr. Dinesh Mittal
Sch J App Med Sci | 2578-2583
DOI : 10.36347/sjams.2020.v08i11.030
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Purpose: To Analyze results of Part Time or Full Time Occlusion Therapy for Amblyopia in children older than 6 years. This was a retrospective consecutive case series analysis of children treated for amblyopia in the Drishti the Vision Eye hospital Indore from January 2018 to January 2020. Materials and Methods: This was a retrospective consecutive case series analysis of children treated for amblyopia at Drishti the Vision eye hospital at Indore. All children received part time or full-time occlusion for the dominant eye. Results: Sixty-eight children older than 6 years at the time of initiation of therapy were included. Age at initiation of therapy ranged from 6 to 14 years. Thirty-two children had Strabismic Amblyopia, 27 had Anisometropic Amblyopia and 9 had a combination of Strabismic and Anisometropic Amblyopia. Fifty out of 68 eyes had improvement in visual acuity following occlusion Therapy. Conclusion: Occlusion therapy yields favorable results in Strabismic and/or Anisometropic Amblyopia, even when initiated for the first time after 6 years of age. Both Full time and part time occlusion therapy are successful. The chances of success decrease as the age at when the occlusion therapy is given increases. The chances of success are more with full time occlusion.
An Observational Study on Late Preterm Neonates from a Post-Graduate Teaching Hospital in North East India
Rajarshi Das, Palash R. Gogoi, Santanu Deb, Prasenjit Paul, Sabrina Yesmin, Pramod Paharia
Sch J App Med Sci | 2584-2588
DOI : 10.36347/sjams.2020.v08i11.031
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Methods: This prospective observational study included the late preterm neonates (340/7 weeks - 366/7 weeks) born at Nazareth Hospital, Shillong, Meghalaya, India for a period of six months. Short term outcome was assessed in the form of morbidity during the study period and at follow up at 2 weeks and 6 weeks. The enrolled neonates were divided into three groups of 340/7 to 346/7, 350/7 to 356/7 and 360/7 to 366/7 weeks. Results: During the study period, 1025 neonates were born at a large tertiary care teaching hospital located at Shillong, Meghalaya, India, of which 72 were late preterm. In the present study the data was collected from 66 late preterm neonates (91.6 %) of which, 26 neonates (39.4 %) were born at 34th week of gestation (WG), 19 neonates (28.8 %) were born at 35th WG and 21 neonates (31.8%) were born at 36th WG. We observed that 22 out of 26 (84.6%) neonates of 34 WG, 17 out of 19 (89.4%) of neonates of 35 WG and only 11 out of 21 (52.3%) required NICU admission because of various associated morbidities. In our study 15.1% late preterm neonates developed hypothermia. We observed that 36.3% neonates developed hypoglycemia. A total of 18 (27.3%) late preterm neonates developed perinatal asphyxia. Respiratory distress syndrome (RDS) was present in 27 out of 66 neonates (40.9%). Feed intolerance developed in 6 out of 66 (9.09%) late preterm neonates. Jaundice developed in 31 out of 66 (46.9%) late preterm neonates. Probable sepsis developed in 17 out of 66 neonates (25.7 %). Sepsis was confirmed in 4 out of 66 (6 %) late preterm neonates. Conclusions: Late preterm infants suffer a large number of inter-current medical problems during the neonatal period, especially increased likelihood of resuscitation in the delivery room, hypothermia, hypoglycemia, jaundice requiring phototherapy, respiratory pathologies, sepsis and feeding intolerance.
Osteoblastoma of the Carpal Scaphoid: A Case Report
Mohamed Rida El Galiou, Houass EY, Boufettal M, Bassir RA, Kharmaz M, Lamrani MO, Berrada MS
Sch J App Med Sci | 2589-2591
DOI : 10.36347/sjams.2020.v08i11.032
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Osteoblastoma is a rare tumor. This is a rare tumor in the carpal bones, only nine cases have been reported in the literature. It is a benign but potentially aggressive tumor, its radioclinic translation is not very specific and its diagnosis is histological. We report the case of carpal scaphoid osteoblastoma in a 17-year-old patient revealed by localized pain and partial functional impotence, and confirmed histologically. Our patient underwent first row resection due to the aggressive nature of the tumor.
Incarceration of the Ulnar Nerve after Dislocated Elbow Fracture: A Case Report and Review of the Literature
Mohamed Rida El Galiou, Houass EY, Boufettal M, Bassir RA, Kharmaz M, Lamrani MO, Berrada MS
Sch J App Med Sci | 2592-2594
DOI : 10.36347/sjams.2020.v08i11.033
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Incarceration of the ulnar nerve after elbow dislocation is a rare complication. The authors report a case of ulnar nerve incarceration over a dislocated elbow fracture. This is a 17-year-old patient attending the emergency room for a fractured dislocated elbow without vascular nerve damage. Faced with the incoercibility of the dislocation, a bloody reduction was decided. The exploration objectified the incarceration of the ulnar nerve. After extrication, the epitrochlea was fixed with two pins and the anterior transposition of the ulnar nerve.
Giant Cell Tumors of the Tendon Sheaths of the Big Toe: A Case Report
Mohamed Rida El Galiou, Houass EY, Boufettal M, Bassir RA, Kharmaz M, Lamrani MO, Berrada MS
Sch J App Med Sci | 2595-2598
DOI : 10.36347/sjams.2020.v08i11.034
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Giant cell tumor of the tendon sheathsare benign tumors of strictly local malignancy with an aggressive tendency. The progressive prognosis is dominated by the risk of recurrence after surgical excision. Their management requires surgery which remains difficult and which must be well planned and correctly executed to avoid recurrence. The authors report the case of a 24-year-old female patient with a giant cell tumor of the tendon sheaths of the big toe. The patient underwent complete tumor resection. The evolution was favorable without recurrence.
Original Research Article
Nov. 23, 2020
Early Clinical Diagnosis of Falciparum Malaria Helps Reduction in Morbidity and Mortality among Children
Dr. Md. Jamshed Alam, Dr. Fakhrul Amin Badal, Dr. Habiba Jesmin, Dr. Most Monira Begum, Dr. Noor Uddin Talukder, Dr. Nazmul Hossain, Dr. Saiful Islam
Sch J App Med Sci | 2599-2603
DOI : 10.36347/sjams.2020.v08i11.035
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Total 100 cases of falciparum malaria, in the age group of 9 months to 12 years, were studied in the paediatric ward of Chittagong Medical College Hospital from March to August, 2003 with the objectives of studying the clinical presentations of falciparum malaria and their response to therapy, in children. Diagnosis of falciparum malaria was done by clinical examination as well as microscopical demonstration of Plasmodium falciparum in blood. Majority cases; 42 were within 4-6 years of age group, amongst them 61% were male and 39% female. Majority cases 31%had malaria during the month of April 17% in May. Regarding regional distribution of patients, most of the patients came from Hill-tracts, Fatikchari 12%, Rangunia 5%, Cox’sbazar 16% Chittagong 21%. Presenting symptoms included fever 100%, vomiting 15%, headache 7%, diarrhea 8%, altered consciousness 28%, respiratory distress 10%, dark urine 14%. Among febfile patients, clinicalstages was present, 29.1% percent cases developed cerebral malaria (10%), pulmorary oedema (21%) black-water fever signs, among complicated falciparum malaria were rise of temperature (100%), pallor (69%), hepatomegaly alone (56%), splenomegaly alone (33%), hepatosplenomegaly 23% and jaundice 22%. Among 6 cases of cerebral malaria, Blantyre coma seale score 3 of more was observed in 78.5% cases and score <3 in 21. 4% cases. The following signs were also observed: brisk tendon reflexes 2805%, positive babinski’s sign 21.4%, convulsion 52% pulmonary oedema 7.2%, abolished tendon reflexes 7.1% constricted pupil 7.1%, nuchal stiffness 14.2%, kernig’s sign 7.1%. Majority of patients 63% had parasite count 500-10,000 their peripheral blood and count was plenty in only 2% cases. Most of the patients were anaemic but 13% cases had sever anaemia. Initial treatment was started with chloroquine in 6 cases, among them 4 cases showed parasite clearance in peripheral blood after 3days of treatment. The rest 2 patients having persistent parasitaemia were
Original Research Article
Nov. 23, 2020
A Retrospective Analysis of 118 Stroke Cases Admitted to Aseer Hospital in Abha: Classification and Associated Factors
Magbool Alelyani, Sultan Alamri, Yasmeen Khalid, Mohammad Mahtab, Ibrahim Hadadi, Manal Alahmari, Raghad Alsultan, Fatimah Albrike, Mohammed Alshehri, Salha Bahkali
Sch J App Med Sci | 2604-2608
DOI : 10.36347/sjams.2020.v08i11.036
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Background: A stroke is a medical disorder in which inadequate flow of blood through the brain contributes to the death of cells. There are two kinds of common strokes, ischemic and hemorrhage. Hypertension, diabetes mellitus and cerebrovascular injury are the risk factors for strokes. This research aimed to classify the most common type of stroke as well as the common risk factors associated with it in one of Saudi Arabia's major hospitals, located in the city of Abha. Methods and materials: From 1/1/2018 to 1/10/2019, data was collected from 118 patients with stroke. Results: The most prevalent type of event was ischemic stroke (91%), with hemorrhagic stroke comprising the remainder (9%). In addition, hypertension was the most common risk factor for stroke. In addition, we found that stroke events associated with hypertension and diabetes in patients over the age of 70 were more likely to occur relative to younger patients, p>0.05. Further study showed no correlation between stroke type and patient age, p>0.05. We also found no connection between the type of stroke and the specific imaging examinations performed, p>0.05 and the type of examination was independent of the stroke stage. Conclusion: We conclude that ischemic stroke was the most common type in the Abha city region of the Kingdom of Saudi Arabia, particularly among aging populations, and the common risk factor associated with stroke was hypertension.
Obturator Dislocation of the Hip: A Rare Sport Injury
Elyazid Houass, Elgaliou MR, Boufetal M, Bassir RA, Kharmaz M, Lamrani MO, Berrada MS
Sch J App Med Sci | 2609-2611
DOI : 10.36347/sjams.2020.v08i11.037
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Dislocation of the hip, in its obturator variety, is a rare entity, especially in sports practice, it requires reduction in less than 6 hours, performed by a qualified surgeon to avoid complications, we report the case of an obturator (anteroinferior) dislocation in a 19-years-old male practicing a sport of contact.
Original Research Article
Nov. 26, 2020
“A Comparative Study of Management of Anemia in Pregnancy by Oral and Parenteral Therapy”
Dr. Homaira Shahreen (Simi)
Sch J App Med Sci | 2612-2615
DOI : 10.36347/sjams.2020.v08i11.038
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Introduction: Iron deficiency anemia is a common problem presented in antenatal patients throughout the developing countries across the world. Its prevalence is estimated to be from 20–80% worldwide with a greater percentage in the third world countries. The higher prevalence of anemia in pregnancy is a cause of concern as it causes considerable morbidity and mortality. The problem of Iron deficiency is more severe in the poor rural and tribal pregnant female population of our country. Aims: We in the present study tried to evaluate the results of treatment of iron deficiency anemia in pregnant females with oral and parenteral iron supplements and evaluate the effects of the treatment on the hemoglobin and iron status. Methods: This prospective cross-sectional study was conducted in the Department of Obstetrics and Gynecology, Rajshahi Medical College Hospital, Rajshahi, Bangladesh for a period of 6 months (January to Jun-2019). The patients were randomly selected from those visiting the OPD of the Department of Obstetrics and Gynecology for ANC. A total of n=78 patients with anemia were included in the study. The patients were evaluated completely including a complete history, clinical examinations and laboratory investigations were ordered with a complete hematological profile including serum iron, serum folate levels, urine, and stool examination. After obtaining the results the patients were separated into three groups Group I, II, & III (mild, moderate and severe) anemia. The mild and moderate groups were given only oral iron supplementation for 2 months and severe anemia was treated with IV iron sucrose for 1 to 2 weeks followed by oral supplementation. Results: The mean age was 24.5 years. The mean Hb levels in Group I was 8.2 ± 2.6 gm/dl and in group II the mean Hb levels were 7.5 ± 1.9 gm/dl and in group III the levels were 6.5 ± 1.1 gm/dl. In the group I the mean Hb levels increased at 8 weeks to 10.4gm/dl. The serum iron pretreatment was 80µgm/dl ........
An Unusual Case of Efferent Limb Obstruction Following Gastrojejunostomy
Dr. Ashok Kumar Sarker
Sch J App Med Sci | 2616-2619
DOI : 10.36347/sjams.2020.v08i11.039
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Efferent loop obstruction is a very rare postgastrectomy obstruction that can occur following Billroth-II or Roux en- Y reconstruction. The most common loop obstruction after gastric surgery is afferent loop obstruction; however, efferent loop obstruction has been reported in rare cases. Here, we report a case of efferent loop obstruction that occurred after gasrtojejunostomy for Gastric outlet obstruction underwent 30 years back. The efferent loop obstruction was successfully resolved by laparotomy.
Original Research Article
Nov. 28, 2020
Variation of Platelet Indices in Differential Diagnosis of Thrombocytopenia – An Observational Study in a Tertiary Care Centre
Debaditya Samanta, Asim Kumar Manna
Sch J App Med Sci | 2620-2624
DOI : 10.36347/sjams.2020.v08i11.040
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Differential diagnosis of thrombocytopenia can be assessed by studying variation of platelet indices. Different platelet indices such as MPV, PDW, P-LCR, Plateletcrit can be used for these purposes. A study of 200 cases of thrombocytopenia were conducted, corroborated there causes with different platelet indices. It was observed that in the hyper-destructive group (viz. due to infective causes, ITP and SLE), MPV, PDW and P-LCR showed an inverse correlation with the platelet count. Whereas, in the hypo-productive group (viz. due to aplastic anaemia, megaloblastic anaemia, and acute leukaemia and drug-induced) and in control group all the parameters showed a direct correlation to their respective platelet counts. However, bone marrow is the gold standard to differentiate between hypo-productive and hyper-destructive thrombocytopenia, it is agreed that more elaborate and controlled studies are needed to ascertain the importance of these readily available platelet indices in term of their sensitivity, specificity, positive and negative predictive values to get a proper idea about the underlying patho-mechanism of thrombocytopenia. These parameters are to be viewed as a guide to understand the basic patho-mechanisms of thrombocytopenia.
Original Research Article
Nov. 28, 2020
The Wound Infection Following Caesarean Section
Dr. Begum Shamsun Naher Shirin, Dr. Rawshan Ara Khanam, Dr. Sheikh Firoz Kabir, Dr. Sabina Parveen, Dr. Binoy Krishna Golder, Dr. Fatema Ruhane
Sch J App Med Sci | 2625-2634
DOI : 10.36347/sjams.2020.v08i11.041
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Objective: In this study our main objective is to evaluate the wound infection following caesarean section. Method: This cross-sectional study was done at Department of Obstetrics & Gynaecology in tertiary Medical College Hospital from July 2018 December 2019. Where 98 patients who develop wound infection after caesarean section in the study period was taken as case. Another 100 patients were taken as control. Result: During the study maximum patients in case (17.3%) and control (15%) group belong to age group 20 to 24 years and among 1050 caesarean section 98(9.33%) patients develop wound infection. Also 97 case group patients and 95 control group faced emergency operation. Conclusion: After many examinations we can conclude that all pregnant women should have ante natal check up by trained personals also they need Health education. Further study is needed for better outcome.
Original Research Article
Nov. 29, 2020
Outcomes in Patients with First Episode of Optic Neuritis
Ebin Jose, Srikumar B, Ram Mohan
Sch J App Med Sci | 2635-2643
DOI : 10.36347/sjams.2020.v08i11.042
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Background: Optic neuritis (ON) is characterized by unilateral or bilateral sudden loss of vision, often accompanied by periocular pain due to idiopathic, inflammatory, infectious or demyelinating causes. When compared to the Western population, various studies from Asia suggest that there is difference in aetiology, clinical presentation and prognosis of optic neuritis. Few Indian studies are available evaluating the natural course following first attack of optic neuritis. Methods: This prospective observational study was conducted on 20 patients. Inclusion criteria included age range of 18 to 50 years, acute unilateral or bilateral optic neuritis with visual symptoms for less than or equal to 1 week associated with at least 2 of the following: colour vision abnormality, pain on eye movement, afferent papillary defect, and abnormal visual-evoked potential (VEP). Patients having toxic, metabolic, vascular, and infective causes for optic neuritis were excluded from the study. CSF study including oligo-clonal band (OCB), S. NMO antibody, MRI Brain and spine were done for all patients. Patients were followed up at 3 months, 6 months and 1 year with detailed clinical examination and VEP to assess visual recovery and development of new neurological deficits. Results: Female (n= 12) preponderance was seen in a ratio of 3: 2. Recurrent optic neuritis was seen in one patient with idiopathic optic neuritis. During one year follow up, 3 patients developed additional neurological deficits of which 2 were having MS and 1 having NMO. Patients with MS were having short segment demyelinating lesion and the one with NMO was having LETM and cord oedema. Bilateral ON was seen in 2 patients (one S. NMO and the other S. anti MOG antibody positive). There was statistically significant association with (p value =0.01) increase in the number of lesions in the follow up MRI brain and development of multiple sclerosis. Visual outcome was better in patients with idiopathic ON and optic......
Original Research Article
Nov. 29, 2020
Sonographic Assessment of Optic Nerve Sheath Diameter and Its Correlation with CSF Opening Pressure in Patients with Idiopathic Intracranial Hypertension
Jobin Mathew, Srikumar B, Dileep R
Sch J App Med Sci | 2644-2650
DOI : 10.36347/sjams.2020.v08i11.043
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Background: Idiopathic Intracranial Hypertension (IIH) has an incidence of about 2.2/100000 in general population. Optic Nerve Sheath Diameter (ONSD) is found to be high in raised intracranial tension. Studies on ONSD and IIH are limited. ONSD measurement is non-invasive compared to spinal manometry. So, measuring the ONSD can be used as a screening tool on outpatient basis in patients suspected to have IIH and also for follow up of patient on treatment. Methods: The aim of this study was to correlate cerebrospinal fluid (CSF) opening pressure with optic nerve sheath diameter measured using ultrasonogram in patients with idiopathic intracranial hypertension and to study changes in optic nerve sheath diameter before Lumbar puncture (LP), one hour after, and 6 months after CSF drainage in patients with idiopathic intracranial hypertension. IIH was diagnosed with modified Dandy’s criteria. A total of 30 cases and 30 controls were included in the study. Trans orbital sonography was done to assess the optic nerve sheath diameter (ONSD) before and after lumbar puncture. CSF opening pressure was measured. ONSD was done in 30 matched controls. Follow up ONSD was done at 6 months. Results: Mean age was 31 years in cases and 30 years in controls. Mean BMI was 35 in cases and 25.5 in controls. Mean ONSD was 6.46±0.67mm in cases, 4.87±0.26mm in control (p<0.001). A positive correlation was found between CSF opening pressure and pre- LP mean ONSD (r=0.584, p<0.001). Post LP mean ONSD was 5.83±0.48mm (p<0.001). Optimum ONSD for detecting IIH was 5.42 mm with sensitivity and specificity of 96.7%. Mean ONSD at 6 months follow up was 5.18±0.58 mm (p<0.001). Conclusions: ONSD measurement can be used as an additional tool to identify patients with IIH. It can also be used to follow up patients on treatment.
Original Research Article
Nov. 29, 2020
Fractures of Capitellum: A Review of 2 Cases Treated by Open Reduction and Internal Fixation with Herbert Screws
Elyazid Houass, M.R.Elgaliou, M.Boufetal, R.A.Bassir, M.Kharmaz, M.O.Lamrani, M.S.Berrada
Sch J App Med Sci | 2651-2654
DOI : 10.36347/sjams.2020.v08i11.044
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Isolated capitellar fractures are an articular lesion with a frontal fracture line. This fracture is uncommon and the diagnosis is often missed. We report two cases of capitellar fracture type 1 according to the classification of Bryan Morrey, treated operatively by open reduction and internal fixation using herbert screws within 48h after injury, The elbow was immobilized for 4 weeks. The patient regained full range of movement at 12 weeks post operatively. There were no instances of infection or avascular necrosis.
Original Research Article
Nov. 29, 2020
NDVH or TAH- Choosing Wisely and Making Safely
Dr. Rabea Khatun, Dr. Sohelee Nargis, Dr. Mir Rabaya Akter, Dr. Mohammad Azizur Rahman
Sch J App Med Sci | 2655-2658
DOI : 10.36347/sjams.2020.v08i11.045
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Objective: In this study our main goal is to evaluate the efficiency and safety between Non-Descent Vaginal Hysterectomy (NDVH) and Total Abdominal Hysterectomy (TAH). Method: This randomized prospective comparative study was carried out Kumudini Women’s Medical College from Jan2019 to Jan 2020. A total of 100 patients requiring hysterectomy were selected from the Outpatient Department and detailed history elicited and general and systemic examinations performed and confounding variables strictly controlled by following inclusion and exclusion criteria were enrolled for this study. Where in group A (n = 50) underwent vaginal hysterectomy (non-descent vaginal hysterectomy, NDVH) which was compared with group B (n = 50) who had abdominal hysterectomy. Results: During the study, in both group most of them were multiparas, followed by in NDVH group 8% had previous pelvic surgeries and 42% had medical illness where as in TAH group, 4% had previous pelvic surgeries and 40.5% had medical illness. In the vaginal group, 25% had undergone concurrent salpingo-ophorectomy whereas 30% in the abdominal group. The mean duration of surgery was 37.05 minutes in the vaginal group, whereas, it was 56.1 minutes in the abdominal group, implying a significant difference (p< 0.05). Similarly, a significantly higher blood loss (248 ml) was noted in the abdominal hysterectomy group, compared to 101.5 ml in the vaginal group (p< 0.05). Conclusion: From our study we can conclude that, patients requiring hysterectomy for benign non prolapse cases may be offered the option of vaginal hysterectomy which has quicker recovery, shorter hospitalization, lesser operative and postoperative morbidity compared to abdominal route.
Original Research Article
Nov. 30, 2020
An Observation of the Hematological Profile and Histopathological Findings in Patients with Cervical Lymphadenopathy
Dr. Shaha Md. Ashrafozzaman, Professor Md. Robed Amin, Dr. Hasina Akhtar
Sch J App Med Sci | 2659-2666
DOI : 10.36347/sjams.2020.v08i11.046
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This cross sectional observational study was carried out with an aim to describe the types of variations in clinical presentation, demographic characteristics, hematological profile & histological findings and etiological pattern of patient having cervical lymphadenopathy. A total of 115 patients presented with cervical lymphadenopathy both inpatient and outpatient department of Medicine in Dhaka Medical College Hospital, during March 2014 to December 2014, were included in this study. A total of 115 consecutive patients having cervical lymphadenopathy both inpatient and outpatient department in the above mentioned hospitals were enrolled in this study to see the clinic-pathological correlation. Almost one third (29.6%) patients belonged to age 21-30 years and the mean age was found 42.1±15.6 years. The association between age with histological findings it was observed that lymphoma was found 27.6% in patients belonged to age 41-50 years, tuberculosis 14(43.8%) patients belonged to age 21-30 years, metastatic carcinoma was 10(41.7%) patients belonged to age 51-60 years, nonspecific lymphadenopathy 11(45.8%) patients belonged to age 21-30 years. Male to female ratio was 2.6:1. More than three fourth patients were married. More than one fourth, patients were laborer, one third were businessman, and others were housewives, student, and unemployed. More than half of the patients came from lower class and others from middle class family.
Original Research Article
Nov. 30, 2020
Pattern of Skin Diseases: Study in Mymensingh Medical College, Mymensingh, Bangladesh
Dr. Rafiqul Islam, Dr. Md. Nazrul Islam, Dr. Mohammed Mosharraf Hossain
Sch J App Med Sci | 2667-2671
DOI : 10.36347/sjams.2020.v08i11.047
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Introduction: Skin diseases are one of the most common health problems seen in the developing countries. It is generally agreed that the pattern of skin diseases differs in different countries, and various factors like environment, economy, literacy, racial and social customs. Objective: To assess the pattern of skin diseases in Mymensingh Medical College, Mymensingh, Bangladesh. Material & Methods: This cross-sectional retrospective study was conducted at outpatient department of Dermatology and Venereology in Mymensingh Medical College, Mymensingh, Bangladesh during the period from January, 2020 to October 2020. A total of 24,280 patients visited OPD for skin and Veneral diseases during the tenure of the study. Among them 18,567 were newly diagnosed patients selected as study participants. 14,012 patients were male and 14,955 patients were female. Results: A total number of 3722(36.96%) cases were parasitic diseases of which 3,642(97.85%) cases were scabies and 80(2.15%) cases were pediculosis. Out of 2,801(27.81%) fungal diseases tinea capitis, tinea corporis, tinea cruris, candidiasis, onychomycosis and pityriasis versicolor were found in 186(6.64%) cases, 1365(48.73%) cases, 465(16.60%) cases, 326(11.64%) cases, 195(6.96%) cases and 264(9.43%) cases respectively. Distribution of the patients according to type of non-infective disease was showed. Among 4,869(57.31%) eczema cases, Seborrheic dermatitis was found in 1,072(22.02%) cases, Pompholyx was in 618(12.69%) cases, Lichen simplex chronicus was in 516(10.60%) cases and undetermined type was in 256(5.26%) cases. Among 473(5.57%) cases of Papulo Squamous Disease, Psoriasis was found in 211(44.61%) cases, lichen planus was in 211(44.61%) cases, pityriasis rosea was in 76(16.07%) cases and Others was in 29(6.13%) cases. Acne was found in 2063(24.28%) cases. Urticaria was found in 1749(84.78%) cases. Vitiligo was found in 314(15.22%) cases. Conclusion: A massive burden of skin diseases is existing mostly.........
Original Research Article
Nov. 30, 2020
Clinical Profile of Febrile Seizure in Children: A Study in a Tertiary Care Hospital, Dhaka, Bangladesh
Md. Nurul Absar, Sahedul Islam Bhuiyan, Farhana Akhter Faruque, Md. Abu Talha
Sch J App Med Sci | 2672-2676
DOI : 10.36347/sjams.2020.v08i11.048
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Introduction: Febrile seizures are one of the common neurological problems encountered in pediatric practice and common cause of convulsions in young infants. Seizure was diagnosed by sudden alteration of behavior with abnormal movement of limbs, trunk, and face that might be associated with abnormal or fixed eye gaze with or without incontinence of urine or stool. In USA, South America and Western Europe between 2% and 5% of all children experience febrile seizure before 5 years. Aim of the study: To evaluate the clinical profile and investigations of febrile seizure in children. Material & Methods: This cross sectional study was conducted in Uttara Adhunic medical college hospital, Uttara, Dhaka, Bangladesh. The study was done in 6 months’ duration (1st November 2010 to 3oth April 2011), on the children of febrile seizure. Hundred (100) patients fulfilling inclusion and exclusion criteria were selected for this study. Data recorded in questionnaires forms into computer and analyzed by using SPSS-15.0 statistical software employing appropriate statistical test and determination of p value. This study was approved by Ethical Committee of the BCPS. Moreover, this study was done following the guideline of BMRC (Bangladesh Medical Research Council). Results: In this study, age distribution of the patients (n=100) were divided into three age groups. Incidence was most common in 1-2 years’ age group (43%), slightly lower in 5 months –1-year group (39%) and incidence declined sharply in 2-6 years’ age group which was 18%. Male to female ratio was 1.27:1. Ninety-two (92%) febrile seizures were of less than 15 minutes’ duration, 95% generalized, and single attack of seizure in 89% cases, incidence of 2 attack in 7% and more than 2 in 4% cases. Conclusion: Family history was positives in significant number of cases. No significant association found between this disease and any antenatal, natal, post-natal or childhood adverse events.
Original Research Article
Nov. 30, 2020
Subclinical Hypothyroidism in Pregnancy: An Overview of Literature and Guidelines
Mohammed A. Kalathingal, Nazia E. Kottasseri, Shajitha T. Veettil
Sch J App Med Sci | 2677-2684
DOI : 10.36347/sjams.2020.v08i11.049
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The prevalence of overt and subclinical hypothyroidism (SCH) during pregnancy is reported to be 0.3-0.5% and 2-3% respectively. In about 5-18% of reproductive women, thyroid autoantibodies are present. Thyroid dysfunction (hypothyroidism, hyperthyroidism and autoimmune diseases) during pregnancy can lead to serious problems for both mother and baby. The multitude of adverse events associated with untreated thyroid disease during pregnancy leads to consider the potential benefits and costs of thyroid dysfunction testing before and during pregnancy. There is controversy over whether to treat subclinical thyroid dysfunction in pregnant women. This article reviews the most important studies associated with SCH and attempts to draw literature-based conclusions on the management of subclinical hypothyroidism in pregnancy.
