الملخص
Benign recurrent intrahepatic cholestasis is an inherited and occasionally sporadic disease presents as recurrent episodes of obstructive jaundice without any obstruction in billiary channel with intervening symptom free periods. Here we are presenting a case of 20-year-old male with a recurrent jaundice and pruritus who later diagnose as BRIC.
الملخص
A hospital based cross sectional study was carried out to analyze diurnal variation of stroke and their association to sleep awake cycle. Four hundred and two patients of stroke admitted in different Medicine Units of Faridpur Medical College and Dhaka Medical College Hospitals from July 2012 to June 2013 were chosen using purposive sampling technique. Enrolled patients were with their first stroke, subsequently proved by CT scan of brain. The initial clinical diagnosis of stroke was made from history and examination obtained from the patient himself or from his/her attendant. The time of onset of stroke was recorded by attending doctor at the time of assessment and recorded on a fixed proforma. Patient who could not give history properly or had no responsible attendant and who had history of head injury, intracranial space occupying lesion or bleeding disorder were excluded from the study. Age ranged from 25 years to 98 years with mean age of 62.02 years (+_SD 11.75 years). Out of 402 patients 59.7% suffered from ischemic stroke. Highest incidence of stroke (26.9%) occurred between 4:01am to 8:00 am and lowest (7.5%) between 8:01 pm to 12:00 am. Among the subtypes, ischaemic stroke has shown a single peak incidence at 4:01 to 8:00 am and lowest between 8:01 pm to 12:00 am. 50 % of ischaemic stroke cases developed between 0:01 am to 8:00 am. In this study, maximum number of patients developed hemorrhagic stroke between 4:01 am to 8:00 am (25.9%) and lowest number developed hemorrhagic stroke between 12:01 pm to 4:00 pm (9.3%). This study confirms the diurnal variation of both hemorrhagic and ischaemic stroke in Bangladesh and most of them occurs in early morning after wakening.
الملخص
The occurrence of tuberculosis of the upper respiratory tract including oral cavity has become uncommon. Isolated tuberculosis in the absence of active pulmonary tuberculosis is very rare clinical entity. Here is a report of primary tuberculosis of tonsil, presented with complaints of sore throat.
الملخص
Objective: Present study was undertaken to find out the long term effect of application of compression probe after haemorrhoidectomy in the treatment of bleeding haemorrhoids. Materials and methods: They study was carried out in the Department of Clinical Surgery, Russian People's Friendship University, Moscow, Russia, from January 1992 to December 2001, on 80 patients, equally divided into two groups, case (haemorrhoidectomy plus application of compression probe) and control (haemorrhoidectomy only). Results: Long term follow up showed higher good outcome in case group (82.1%) compared to control (53.8%) (P<0.05), satisfactory and unsatisfactory outcome was higher in control group (17.9% and 28.2%) compared to case group (12.8% and 5.1%). Conclusion: Application of compression problem after haemorrhoidectomy in patients with bleeding haemorrhoids gives better long term results.
الملخص
Knowledge about the existing disease pattern and health seeking behavior is essential to provide need based health care delivery to any population and to make the health care system more pro-poor. A community based cross sectional study was conducted among 493 systematically selected households in the Modhukhali Upazilla of Faridpur District to determine the prevailing disease pattern and health seeking behavior in rural Bangladesh. Data were collected through face-to-face interview of the selected respondents. More than half of the respondents gave history of illness of her or her family members during the preceding 15 days. Fever (33.2%), gastrointestinal diseases (24.9%) and respiratory diseases (17.8%) were the most reported complaints. Overall, there were no discernible differences in the likelihood of seeking traditional or any kind of care considering socio-demographic variables and prevailing disease types. Occupation of household head as day labor or in agriculture and suffering from gastrointestinal diseases positively predicted use of para-professionals. Use of un-qualified allopths was negatively predicted by the male gender or literacy of the household head and presence of gastrointestinal, respiratory and other types of diseases and positively predicted by occupation of the household head in agricultural field or as day labor. Use of qualified allopaths was positively predicted by respiratory, skin/eye/ENT and other types of diseases and also by standard of living and relationship of the respondents with household head and negatively predicted by agricultural or day labor work of the household head. Existence of several distinct therapeutic systems in a single cultural setting was found to be an important feature of health care system in the study area. This study concluded that it is important to develop a need based health care delivery system and actions should be taken to improve the overall scenario of health system of rural Bangladesh.
الملخص
A hospital based cross sectional study was carried out to analyze prevalence of risk factors for stroke in hospitalized patient in a medical college hospital. 100 patients were chosen using purposive sampling technique. Highest incidence of stroke was between the 6th and 7th decade. Patients came from both urban (54%) and rural (46%) areas and most of them belong to the low-income group (47%). In occupational category; service holder (28%) and retired person (21%) were the highest groups. Most of the study subjects were literate (63%). CT scan study revealed that the incidence of ischaemic stroke was 61% and haemorrhagic stroke 39%. Analysis indicated hypertension as major risk factor for stroke (63%) and major portion of the patients (42.85%) were on irregular or no treatment. Twenty four percent of the patients had heart diseases and out of 24 patients 45.83% were suffering from ischaemic heart disease. The present study detected diabetes in 21% patients. Fifty three percent of the study subjects were smoker, 39% patients had habit of betelnut chewing. Out of 26 female patients, only 23% had history of using oral contraceptives. Majority of the patients were sedentary workers (46%). Thirty seven percent of the stroke patients were obese. Among the stroke patients 9% had previous history of stroke and 3% had TIA respectively. Most of the patients (21%) were awake while they suffered from stroke and the time of occurrence was mostly in the afternoon (46%). This study found that hypertension, cigarette smoking, ischaemic heart disease and diabetes mellitus are the major risk factors prevalent in our community while other risk factors demand further study.
الملخص
Hypertension is an important independent predictor of cardiovascular disease, cerebrovascular accidents and death. The prevalence of cardiovascular diseases and hypertension is rapidly increasing in developing countries. A cross sectional study was conducted among 103 hypertensive patients during December 2009 to June 2010 in Goshair Hat Upazilla of Shariatpur District to determine the socio-demographic, clinical characteristics and status of control of hypertension in rural population. Respondents were distributed more or less equally among males and females. The mean +_ SD and median age of the respondents were calculated as 59.97 +_ 11.12 years, with 64% of them were included in the age group of 51 to 70 years. More than half of the respondents were housewives (51.5%), which were followed by businessmen (21.4%). Every three of five patients were over weight, while 22.3% respondents were obese. One third of the respondents were also diabetic (33%). None of the 103 patients had achieved the target for SBP (Systolic blood pressure) control (<140mm of Hg) and only 21.4% of the patients had achieved the target for DBP (Diastolic blood pressure) control (<90 mm of Hg). Again none of the diabetic hypertensive patients had achieved the target for SBP control (<130mm of Hg) and only one patient had achieved the target for DBP control (<80 mm of Hg). Overall five patients were found to have uncontrolled and severe hypertension (BP >180/110 mm of Hg), all of whom were female. From this study control of hypertension was found poor among rural hypertensive population. For effectively combating the burden of hypertension in this population, education and awareness about hypertension needs to be given priority.
الملخص
Background: Conventional coronary artery bypass surgery (CABG) is associated with substantial morbidity caused by cardiopulmonary bypass (CPB) and median sternotomy. Here we described an innovative technique to perform complete revascularization through a left lateral thoracotomy without CPB (ThoraCAB). Methods: From September 2005 to December 2008 a total 83 patients underwent ThoraCAB in National Institute of Cardio Vascular Diseases (NICVD). The patient is positioned with the left side elevated to 45 degree. A 6 to 8 inches long incision is made over the left 4th or 5th intercostal space from just medial to the nipple to the anterior axillary line. The left internal mammary artery (LIMA) is harvested as a pedicle graft under vision. Distal coronary anastomosis is completed first on the beating heart using a stabilizer, followed by proximal anastomoses on the descending aorta. Peroperative and postoperative complication the arrhythmia hypotension wound infection death was observed. Results: Complete revascularization was achieved in all patients. The number of grafts averaged 2.18±1.08 per patients. One patient died (1.2%) due to severe respiratory acidosis. One patient (1.2%) was converted to CPB due to arrhythmia. No strokes were observed. Of these patients, 7.2% developed new onset postoperative atrial fibrillation. Conclusion: ThoraCAB has been feasible in the vast majority of the patients requiring CABG surgery. The prevalence of the post operative atrial fibrillation was low. Left lateral thoracotomy offers an attractive and effective alteration to Off Pump median sternotomy.
الملخص
F-wave latency measurement is a sensitive parameter of diabetic neuropathy than the conduction velocities. This study was carried out to measure F-wave latency and to see which conduction parameters are affected frequently and early. A total number of 62 patients of which 32 newly diagnosed and 30 controls were included in the study. Ulnar motor nerve conduction velocity was found slowed in 6(18.75%) diabetic subjects, but F-wave latency was found prolonged in 16(50%) diabetic subjects. 28(87.5%) diabetic subjects had normal peroneal nerve conduction velocity but peroneal F wave was found prolonged in 17(53.12%) diabetic subjects. This result suggests that F-wave latency is more frequently & early involved conduction parameter in diabetic subjects.