A Comparative Study of Collagen Sheet versus 1% Silver Sulfadiazine Dressing in Superficial Partial Thickness Burns.

Burn injury causes a lot of suffering. The goal of burn management is to achieve rapid wound healing, pain relief, rehabilitation with minimum scars and optimal functional ability. Objective of this study was to compare the efficacy of collagen sheets and 1% silver sulfadiazine dressing (SSD) for superficial partial thickness burns. This prospective observational study was conducted among the patients of Department of Plastic surgery, Dhaka Medical College Hospital, and Sheikh Hasina National Institute of Burn and Plastic Surgery, Dhaka, from 1st April 2020 to 31st March 2021. Total 60 patients with superficial partial thickness burns by purposive sampling 30 patients of them were treated with collagen sheet dressing (Group A) and 30 patients with 1.0% silver sulfadiazine dressing (Group B). First case was selected by tossing a coin. Then every alternate patient was provided the same kind of dressing material (either collagen sheet or 1.0% silver sulfadiazine). Data were collected by semi structured data collection sheets. Pearson's chi-square test and student's 't' test were used for data analysis (p value was significant at <0.05). It was observed that a total of 18(60.0%) patients belonged to age <10 years in Group A and 17(56.7%) patients in Group B. The mean age was 14.9±14.2 years in Group A and 11.6±10.2 years in Group B. Good quality of healing was significantly higher in the collagen group compared to the SSD group (<0.05). The mean complete healing time in the collagen group was 10.47±2.21 days and in the 1.0% SSD group were 13.07±2.33 days. The mean healing time was significantly lower in the collagen group compared to the 1.0% SSD group (p<0.001). There was no significant difference in infection rate between the two groups (p>0.05). Considering the overall outcome, Collagen sheet dressing decreases pain, reduces the need for analgesics, aids in early healing as compared to the patients treated with 1% silver sulfadiazine.

The effects of physical vibration on heart rate variability as a measure of drowsiness.

We investigated the effects of low frequency whole body vibration on heart rate variability (HRV), a measure of autonomic nervous system activation that differentiates between stress and drowsiness. Fifteen participants underwent two simulated driving tasks for 60 min each: one involved whole-body 4-7 Hz vibration delivered through the car seat, and one involved no vibration. The Karolinska Sleepiness Scale (KSS), a subjective measure of drowsiness, demonstrated a significant increase in drowsiness during the task. Within 15-30 min of exposure to vibration, autonomic (sympathetic) activity increased (p < .01) in response to the stress of maintaining alertness and performance when drowsy, and peaked at 60 min (p < .001). Changes in three other HRV domains [higher LF/HF ratios, lower RMSSD (ms) and pNN50 (%) values] were consistent with increased sympathetic activation. These findings have implications for the future development of equivalent drowsiness contours leading to improvements in road safety. Practitioner summary: The effects of physical vibration on driver drowsiness have not been well investigated. This laboratory-controlled study found characteristic changes in heart rate variability (HRV) domains that indicated progressively increasing neurological effort in maintaining alertness in response to low frequency vibration, which becomes significant within 30 min. ABBREVIATIONS: ANS: autonomic nervous system; Ctrl: control; EEG: electroencephalography; HF: the power in high frequency range (0.15 Hz-0.4Hz) in the PSD relected parasympathetic activity only; HRV: heart rate variability; KSS: karolinska sleepiness scale; LF: the power in low frequency range (0.04 Hz-0.15Hz) in the PSD reflected both sympathetic and parasympathetic activity of the autonomic nervous system; LF/HF ratio: the ratio of LF to HF indicated the balance between sympathetic and parasympathetic activity; RMSSD: the root mean square of difference of adjacent RR interval; pNN50: the number of successive RR interval pairs that differed by more than 50 ms divided by the total number of RR intervals; RR interval: the differences between successive R-wave occurrence times; PSD: power spectral density; RTP: research training program; SD: standard deviation; SEM: standard error of the Mean; Vib: vibration.

Exceptional Multiple Foreign-Body Ingestion by a Patient with Schizophrenia.

Swallowing foreign body in adult is uncommon. This mostly occurs accidentally or in psychologically unsound patient. A 32-years-old male patient with abdominal pain admitted in surgery department of Mymensingh Medical College Hospital, Mymensingh, Bangladesh with a history of swallowing various objects. After endoscopic confirmation and psychological evaluation he underwent laparotomy and 29 different objects were removed from his stomach by Gastrotomy. He was psychiatrically evaluated after recovery from operation and was found to be suffering from Schizophrenia with cannabis use. The aim of reporting this case can raise awareness at the patients complains should be taken seriously to prevent morbidity and even mortality.

Giant Retroperitoneal Fibrolipoma - A Case Report.

Lipomas are common benign adipose tumours generally located at superficial locations but deep seated lipomas are rather infrequent out of which retroperitoneal location of giant lipoma is rare. Fibrolipoma is one of the uncommon variant of lipoma. There is no different evidence in clinical profile, management, and prognosis of fibro lipoma from other variants of lipomas. Complete surgical excision is the treatment of choice. Here we present a case of 13 year old lady with giant retroperitoneal fibrolipoma which was completely excised through laparotomy. And the patient remains well one year after surgery without recurrence of the disease.

Correlation between Clinical Diagnosis and Colonoscopic Findings of Patients Presented with Lower Gastrointestinal Bleeding.

Lower gastrointestinal bleeding is a frequently encountered problem in general medical practice. This bleeding comes from a site distal to ligament of Treitz. But it may also come from upper gastrointestinal tract when it is massive and pass through the stool. This study was intended to explore the causes of lower gastrointestinal bleeding and correlating them with their colonoscopic findings. This study was cross-sectional prospective. Sample was taken purposively. Out of 200 patients which were selected for the study, 122(61%) were male and 78(39%) were female with a male to female ratio of 5:3. The ages of the patients were ranging from 5 to 80 years with the mean age of 41.9±15.0 years; maximum 38(19%) patients were in 51 to 60 years. All patients were presented with per rectal bleeding & underwent colonoscopy & maximum 57(28.5%) patients were diagnosed as hemorrhoids, followed by colorectal cancer in 55(27.5%) cases. In 10(5%) cases of haemorrhoids 2nd pathology was found associated with it. In 32(16%) cases colonoscopic findings were normal. It was concluded that the most common cause of lower gastrointestinal bleeding was hemorrhoids followed by colorectal cancer. But several cases of colon cancer were misdiagnosed clinically as colitis. So clinical diagnosis should be correlated & confirmed by colonoscopy and biopsy.

A giant hepatic cyst.

Liver cysts occur in approximately 5% of the population. However, only about 5% of these patients ever develop symptoms. In general, cysts are thin-walled structures that contain fluid. Most cysts are single, although some patients may have several. Here we report a case of a giant hepatic cyst in a 50 year old female who was admitted in our Hospital for right upper quadrant pain and abdominal lump. She was thoroughly investigated with ultrasonography, and computerized tomography scan of the abdomen along with other supportive investigations, and was diagnosed as having a 30×25cm cyst in the right lobe of the liver. Exploratory laparotomy and partial cystectomy with drainage & marsupialization were performed in the patient.