RESUMEN
Retrieval of stone by endoscopic papillotomy, laparoscopic choledochotomy or open choledochotomy is the treatment of choice for choledocholithiasis. Published literature shows that the recurrence rate is 4% to 24% with existing method of treatment. We have treated 8 patients who admitted with recurrent choledocholithiasis in the department of Hepato-Biliary-Pancreatic and Liver Transplant Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh in the period of January 2016 to December 2019. None had intrahepatic duct abnormality or stones. All patients underwent either ERCP stenting, open choledocholithotomy or both 16 to 84 months back. Management policy is designed and outcome is observed on these patients. There were 3 males and 5 females; age ranges 18 to 60 years. The common bile duct (CBD) diameter of all patient ranges from 15 to 24mm. The shape of CBD is different from normal variant; S shaped, saculated, grossly dilated with terminal narrowing. Considering the anatomical abnormality and recurrence of disease we have removed the abnormal part of common bile duct along with stones and the operation was completed by Roux-en-Y hepaticojejunostomy. All patients were completely symptom free for 6 to 48 months after surgery. Removal of abnormal part of common bile duct with reconstruction in the form of Roux-en-Y hepatico-jejunostomy may be considered for treating choledocholithiasis with abnormal CBD (abnormally dilated, abnormally shaped, angulated or sacculated) however, long-term follow up is required for final comment.
Asunto(s)
Coledocolitiasis , Laparoscopía , Adolescente , Adulto , Anastomosis Quirúrgica , Colangiopancreatografia Retrógrada Endoscópica , Coledocolitiasis/diagnóstico , Coledocolitiasis/cirugía , Conducto Colédoco/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Esfinterotomía Endoscópica , Resultado del Tratamiento , Adulto JovenRESUMEN
Finite element (FE) simulation plays a major role in computing stress and predicting the failure of biomedical components. Normally in past, researchers focused on developing a global computational model from the scanned data of patients to analyze the stresses and deformations. To compute the wear of the hip prosthesis, mostly the global model (GM) is used to predict the expected life for million cycles using nodal updating technique which leads to high computational effort and time. The proposed work utilizes a submodeling finite element technique to analyze the contact pressure and wear of biomaterials for three different combinations in hip prosthesis including metal, ceramic and polycrystalline diamond materials. Initially the global model boundary and loading conditions are transferred to the submodel. The mesh is refined further using finer mesh and then the results are computed which consumes lesser time. The contact stress as well as the linear wear of biomaterials is found to be quite high for the local model (LM) when compared with the global model. However, no changes in volumetric wear of these biomaterials are observed when compared with previous experimental results. The computational time as well as accuracy in estimating the contact stress and the wear of bearings is improved effectively. Among local model with different element sizes, 0.75 mm element size of local model showed improved results in estimating the contact stress and linear wear of bearing.
Asunto(s)
Análisis de Elementos Finitos , Prótesis de Cadera , Presión , Diseño de Prótesis , Falla de Prótesis , Humanos , Ensayo de Materiales/métodos , Modelos Teóricos , Estrés MecánicoRESUMEN
The purpose of this study is to diagnose Legg-Calve-Perthes disease by computed radiography and Magnetic resonance imaging and accurate staging and correlating the findings of these two modalities. Thirty five (35) patients complaining pain in groins and painful walking, after thorough physical examinations were sent to Department of Radiology & Imaging, Mymensingh Medical College Hospital, Mymensingh, Bangladesh for computed radiography and Magnetic Resonance Imaging examination. This cross sectional study was conducted in the Department of Radiology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from July 2016 to June 2018. Legg-Calve-Perthes disease among the selected 35 cases were started at the age of 5(2.9%) and age range of the patients were 5-13 years; mean age was (9.63±1.82) years and most of them belonged to 8-10 years of age (51.4%). Patients with Legg-Calve-Perthes disease had been suffering from pain in right and left groins forvarious durations. Maximum duration was 1-2 years (~88.57%). Maximum proportion of diagnosed patients was delivered by normal delivery (60%) and maximum proportion of patients was premature (65.7%). Most of the patients were low birth weight baby (65.7%). Here chi-square test was done and found no significant relationship between delivery mode and birth weight in case of Legg-Calve-Perthesdisease (x²=1.712) (P=0.191). The result of the X-ray and MRI findings by cross table of chi square test found fair inter relationship between two diagnostic instruments. Result found fine difference in staging of the disease between X-ray and MRI findings. It can be said that MRI definitely a better tool for early diagnosis of Legg-Calve-Perthes disease and its staging but X-ray modality can be used. A primary tool for diagnosis and staging of the disease can be done where the MRI facility is not available or cost expensive for patient.
Asunto(s)
Enfermedad de Legg-Calve-Perthes/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Radiografía , Adolescente , Bangladesh , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Masculino , Dolor/etiologíaRESUMEN
Communicated by Ramaswamy H. Sarma.
Asunto(s)
Flavonoides/química , Quinasa I-kappa B/química , Simulación del Acoplamiento Molecular , Proteínas Serina-Treonina Quinasas/metabolismo , Animales , Dominio Catalítico , Línea Celular Tumoral , Citocinas/metabolismo , Flavonoides/farmacología , Humanos , Ratones , Consumo de Oxígeno/efectos de los fármacos , Unión Proteica/efectos de los fármacos , Células RAW 264.7 , Transducción de Señal/efectos de los fármacos , TermodinámicaRESUMEN
This study was done to know the real status of immune response to Hepatitis B vaccine among the pentavalent vaccinated children as per EPI schedule of Bangladesh. It was prospective observational study done in the EPI corner of Paediatric OPD of Dhaka National Medical College & Hospital (DNMCH), Dhaka from July 2015 to July 2016. Sixty (60) children ranging from 9 months to 2 years of age, who received pentavalent vaccination (Hepatitis B + DPT + Hib) according to EPI schedule, were included. The testing for anti-HBs titres were conducted in the Department of Virology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Out of 60 children, 9(15%) had anti-HBs titres <10 IU/L (non-protected) while 51(85%) had anti-HBs titres >10 IU/L (protected). Twenty seven (27) were male and of them 21(77.8%) protective and 6(22.2%) non-protective. Thirty three (33) were female, out of them 30(90.9%) protective while 3(9.1%) non-protective. The difference was not significant between male and female (p=0.156). Fifty (50) children received vaccination by EPI (Government) (pentavalent) out of which 9(18%) non-protective and 41(82%) protective level. However, 10 children received privately Hepatitis B vaccination of which all developed protective level. The difference was not significant between Government (EPI) and privately vaccine (p=0.145). Most of the children showed positive immune response after pentavalent vaccination.
Asunto(s)
Vacunas contra Hepatitis B , Virus de la Hepatitis B , Hepatitis B , Bangladesh , Niño , Femenino , Hepatitis B/inmunología , Hepatitis B/prevención & control , Anticuerpos contra la Hepatitis B , Vacunas contra Hepatitis B/inmunología , Virus de la Hepatitis B/inmunología , Humanos , Lactante , Masculino , Estudios Prospectivos , VacunaciónRESUMEN
Hip implants subject to gait loading due to occupational activities are potentially prone to failures such as osteolysis and aseptic loosening, causing painful revision surgeries. Highly risky gait activities such as carrying a load, stairs up or down and ladder up or down may cause excessive loading at the hip joint, resulting in generation of wear and related debris. Estimation of wear under the above gait activities is thus crucial to design and develop a new and improved implant component. With this motivation, this paper presents an assessment of wear generation of PCD-on-PCD (poly crystalline diamond) hip implants using finite element (FE) analysis. Three-dimensional (3D) FE model of hip implant along with peak gait and peak flexion angle for each activity was used to estimate wear of PCD for 10 million cycles. The maximum and minimum initial contact pressures of 206.19 MPa and 151.89 MPa were obtained for carrying load of 40 kg and sitting down or getting up activity. The simulation results obtained from finite element model also revealed that the maximum linear wear of 0.585 µm occurred for the patients frequently involved in sitting down or getting up gait activity and maximum volumetric wear of 0.025 mm3 for ladder up gait activity. The stair down activity showed the least linear and volumetric wear of 0.158 µm and 0.008 mm3, respectively, at the end of 10 million cycles. Graphical abstract Computational wear assessment of hip implants subjected to physically demanding tasks.
Asunto(s)
Simulación por Computador , Prótesis de Cadera , Falla de Prótesis , Análisis de Elementos Finitos , Marcha/fisiología , Humanos , Presión , Rango del Movimiento Articular , Estrés MecánicoRESUMEN
Mortality and morbidity was assessed after adoption of a systematic care for patient with pancreatoduodenectomy starting from patient selection and preparation, operative technique, and postoperative care. In this prospective study seventy patients who underwent pancreatoduodenectomy for periampullary carcinoma with curative intent between January 2010 and December 2014 were carefully analyzed prospectively. Patients were selected those who had ampullary carcinoma, lower bile duct carcinoma and small size carcinoma head of pancreas without local invasion and distant metastasis, and the patient who did not have any major disabling comorbid diseases. All patients were assessed uniformly before surgery and deficiency were corrected up to normal level before operation. Pancreatoduodenectomy and standard lymphadenectomy was performed meticulously with minimum blood loss. The pancreatojejunal reconstruction was performed using duct-to-mucosa method mostly. A nasojejunal feeding tube was placed in most patients for starting postoperative early oral feeding. Broad spectrum antibiotics and the epidural analgesia were mostly prescribed for good control infection and pain. Proper nutrition was maintained in calculative way through central venous line and nasojejunal feeding tube in the early postoperative period. General care, early mobilization and chest physiotherapy were given routinely in each patient. Seventy-seven percent (n=54) patients did not have any postoperative complications and they were discharged from hospital within 12-14 postoperative days. The morbidity occurred in 16 patients (23%) and most common complication was wound infection (18%, n=9). The rest complications were pancreatojejunal anastomotic leakage - 2, hepaticojejunal anastomosis leakage - 1, melaena - 1, intra-abdominal abscess - 1, intra-abdominal hemorrhage - 1, and renal dysfunction - 1. The mortality rate was 5.7% (n=4), causes of death were massive myocardial infarction; 1, failure of reversal from anesthesia; 1, massive intraabdominal bleeding; 1 and CV catheter related severe sepsis; 1. Review of recent published literature revealed that mortality and morbidity our series is better than low volume center and almost similar with high volume center of pancreatoduodenectomy surgery. Our systematic management policy of careful patient selection, planned approach in the form of proper work up, meticulous conduction of the procedure, appropriate postoperative care provides an acceptable morbidity and mortality after pancreatoduodenectomy.
Asunto(s)
Ampolla Hepatopancreática , Neoplasias Pancreáticas , Pancreaticoduodenectomía , Ampolla Hepatopancreática/cirugía , Humanos , Neoplasias Pancreáticas/cirugía , Pancreaticoduodenectomía/mortalidad , Complicaciones Posoperatorias , Estudios Prospectivos , Estudios Retrospectivos , UniversidadesRESUMEN
Diabetic maculopathy is characterised by increased capillary leakage in the main retinal vessels and by alterations in the microcirculation of the macula. Maculopathy occurs frequently in type 1 and type 2 diabetic patients. Prevalence is higher in type 2 than in type 1 diabetic patients. Factors associated with the development of maculopathy are mostly unknown. As maculopathy is the main cause of vision deprivation in diabetic patients it is essential to know the associations and risk factors of diabetic maculopathy so that appropriate measures can be taken to prevent as well as treat diabetic maculopathy. We started the research work to find out the relation between diabetic maculopathy and various associated factors and risk factors for patients with diabetic retinopathy with maculopathy. This cross-sectional observational study done at the Department of Ophthalmology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka & National Institute of Ophthalmology & Hospital (NIO & H), Sher-e-Bangla Nagar, Dhaka, Bangladesh from January 2006 to June 2006. In this study out of 50 patients, diabetes was controlled in 20(40%) patients and uncontrolled in 30(60%). A significant percentage of patients (40%) had elevated blood pressure. Diabetic autonomic neuropathy was observed in 24% cases and polyneuropathy was observed in 36% cases. It is evident that diabetic maculopathy has association with dyslipidaemia, abnormal renal function due to nephropathy. This study lighted on the association of diabetic maculopathy with diabetic nephropathy, cardiac abnormalities and diabetic neuropathy.
Asunto(s)
Retinopatía Diabética/epidemiología , Mácula Lútea/patología , Adulto , Anciano , Anciano de 80 o más Años , Bangladesh/epidemiología , Estudios Transversales , Retinopatía Diabética/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de RiesgoRESUMEN
Activation cross sections of proton induced nuclear reactions on palladium were measured up to 80MeV by using the stacked foil irradiation technique and gamma ray spectrometry. The beam intensity, the incident energy and the energy degradation were controlled by a method based on flux constancy via normalization to the excitation functions of monitor reactions measured in parallel. Excitation functions for direct and cumulative cross-sections were measured for the production of (104m,104g,105g,106m,110m)Ag, (100,101)Pd, (99m,99g,100,101m,101g,102m,102g,105)Rh and (103,97)Ru radioisotopes. The cross section data were compared with the theoretical predictions of TENDL-2014 and -2015 libraries. For practical applications thick target yields were derived from the measured excitation functions. Application in the field of medical radionuclide production is shortly discussed.
RESUMEN
Wear is the major cause of implant failure, resulting in expensive revision surgeries of total hip arthroplasty. Therefore, understanding of wear mechanism and its progression is crucial to improve the physiological performance of implants. This paper presents a three-dimensional (3D) finite element (FE) wear modeling approach to estimate evolution of wear in hard-on-hard bearing components with the effect of cup abduction angle. Three bearing couples were considered, and they were PCD-on-PCD, Al2O3-on-Al2O3 and Si3N4-on-Si3N4, while the cup abduction angle varied from 35° to 70° with an increment of 5°. By adopting actual physiological hip gait loading and rotational movement for normal walking cycle in FE modeling, the contact pressure and the sliding distance were calculated to predict wear. A femoral head of 32 mm in diameter was considered, while a constant frictional contact at the inference between head and cup was used. During simulation, the geometry of cup surface was updated at a reasonable interval of gait cycles to consider the effect of wear. Wear was simulated for up to 20 million cycles which is an equivalent of 20 years of implant's life in human body. Simulation results showed that compared to other two bearing couples, the predicted linear and volumetric wear in PCD-on-PCD couple exhibited the least wear evolution for all cup angles considered. The increase in abduction angle from 35° to 70° decreases the volumetric wear by 28 % for all three bearing couples, due to the reduction in sliding distance. Steep cup angle, e.g., 70° for Al2O3 and Si3N4 bearing couples, encountered edge contact, which leads to more wear. Further, wear results were discussed and analyzed with respect to in vitro and/or clinical studies available in the literature to justify the efficacy of wear modeling.
Asunto(s)
Artroplastia de Reemplazo de Cadera , Falla de Prótesis , Análisis de Elementos Finitos , Marcha , HumanosRESUMEN
Stroke is a leading cause of death and disability worldwide. While the immediate consequence of stroke include permanent cognitive deficits, paralysis, visual impairment and sensory disturbances; stroke also results in long term dysregulation of sleep and mood, which may be equally disabling. The influence of ischemic stroke on circadian rhythm regulation, which is strongly linked to sleep and mood, may thus potentially influence long term recovery in stroke patients. Stroke induces immediate changes in the timing of pineal melatonin secretion, indicating that cortical and basal ganglia infarction impacts the timing of melatonin rhythms. This study was done to find out the time of onset of most of the ischemic stroke attack and to determine the outcome of ischemic stroke during hospital stay. All ischemic stroke patients admitted in Medicine wards in Comilla Medical College Hospital during the period of 1st November 2010 to 30th April 2011 included in this study. After admission, a careful history and a thorough clinical examination was carried out. Data collection was done on a preset questionnaire which involved to identify the risk factors, the time of onset of ischemic stroke, and outcome during hospital stay. All the cases were investigated. Among the 50 ischemic stroke patients, 68% were male and 32% female. Maximum age groups were 61-70 years (50%). By occupational category, maximum were retired persons (46%); 68% were hypertensive, 38% smoker and 16% had diabetes. Dyslipidemia was present in 44% patients. Most of the ischemic stroke (44%) occurred in the morning to late morning (6:01AM-12:00PM) and majority (80%) of the patients was discharged with residual neurological dysfunction. This study supports the presence of a circadian pattern in the onset of ischemic stroke, with higher risk in the morning to late morning. Most of the patients were discharged with residual neurological dysfunction.
Asunto(s)
Isquemia Encefálica/epidemiología , Ritmo Circadiano , Accidente Cerebrovascular/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Isquemia Encefálica/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Accidente Cerebrovascular/etiologíaRESUMEN
Due to their excellent biodegradability characteristics, Mg and Mg-based alloys have become an emerging material in biomedical implants, notably for repair of bone as well as coronary arterial stents. However, the main problem with Mg-based alloys is their rapid corrosion in aggressive environments such as human bodily fluids. Previously, many approaches such as control of alloying materials, composition and surface treatments, have been attempted to regulate the corrosion rate. This article presents a comprehensive review of recent research focusing on surface treatment techniques utilised to control the corrosion rate and surface integrity of Mg-based alloys in both in vitro and in vivo environments. Surface treatments generally involve the controlled deposition of thin film coatings using various coating processes, and mechanical surfacing such as machining, deep rolling or low plasticity burnishing. The aim is to either make a protective thin layer of a material or to change the micro-structure and mechanical properties at the surface and sub-surface levels, which will prevent rapid corrosion and thus delay the degradation of the alloys. We have organised the review of past works on coatings by categorising the coatings into two classes-conversion and deposition coatings-while works on mechanical treatments are reviewed based on the tool-based processes which affect the sub-surface microstructure and mechanical properties of the material. Various types of coatings and their processing techniques under two classes of coating and mechanical treatment approaches have been analysed and discussed to investigate their impact on the corrosion performance, biomechanical integrity, biocompatibility and cell viability. Potential challenges and future directions in designing and developing the improved biodegradable Mg/Mg-based alloy implants were addressed and discussed. The literature reveals that no solutions are yet complete and hence new and innovative approaches are required to leverage the benefit of Mg-based alloys. Hybrid treatments combining innovative biomimetic coating and mechanical processing would be regarded as a potentially promising way to tackle the corrosion problem. Synergetic cutting-burnishing integrated with cryogenic cooling may be another encouraging approach in this regard. More studies focusing on rigorous testing, evaluation and characterisation are needed to assess the efficacy of the methods.
RESUMEN
Cup wear and inclination on the pelvic bone are significant factors, which change the contact of the articulating surfaces, thus, impacting the long-term performance of hip implants. This paper presents a finite element (FE) analysis of the contact of the dual mobility implants under the influence of cup wear and inclination. A 3D FE model of the implant was developed with the application of equivalent physiological loading and boundary conditions. Effects of cup inclination angle ranging from 45° to 60° and the wear depth ranging from 0 to 2.46 mm equivalent to up to 30 years of the implant's life on the contact pressure and von Mises stress were investigated. Simulation results show that the contact pressure and von Mises stress decrease significantly with a modest wear depth and remains quite in-sensitive to the cup inclination angle and wear depth up to 1.64 mm. With wear depth further up to 2.46 mm, the cup thickness (i.e. cup thinning on worn region) may be more predominant than increasing of contact area between the cup and the head. The wear on the inner surface of the cup is found to rule out the overall contact pressure and stress in the implant. Furthermore, individual and combined effects of both important parameters are analysed and discussed with respect to available clinical/laboratory studies.
Asunto(s)
Prótesis de Cadera , Diseño de Prótesis , Análisis de Elementos Finitos , Humanos , Ensayo de Materiales , Modelos Teóricos , Presión , Estrés Mecánico , Propiedades de SuperficieRESUMEN
Amebic liver abscess is a tropical disease. It is not uncommon in Bangladesh. Given the often nonspecific nature of complains related to amebic liver abscess, this study was carried out to identify the most common presentation. This hospital based cross sectional study was carried out in 30 cases of amebic liver abscess in the Department of Medicine, Gastroenterology and Hepatology, Comilla Medical College Hospital, Bangladesh. Clinical and laboratory informations were recorded including symptoms, signs, location and number of abscess. Among 30 patients, 27 were male (90%) and 3 female (10%), mean age of male and female were 42±11 and 52±8 respectively. Common clinical symptoms were fever (93%) and abdominal pain (93%). Common signs were right upper quadrant tenderness (60%), hepatomegaly (67%). Most of the patient had single abscess (80%) and location of abscess was predominantly in the right lobe (77%). Radiological abnormality on x-ray chest was present in 30% cases. Common clinical presentation of amebic liver abscess patients were fever and right upper abdominal pain. Duration of symptoms was more than two weeks in most cases.
Asunto(s)
Amebicidas/uso terapéutico , Entamoeba histolytica , Absceso Hepático Amebiano , Succión/métodos , Dolor Abdominal/etiología , Adulto , Antígenos de Protozoos/sangre , Bangladesh/epidemiología , Estudios Transversales , Diagnóstico Diferencial , Entamoeba histolytica/efectos de los fármacos , Entamoeba histolytica/inmunología , Femenino , Fiebre/etiología , Humanos , Hígado/diagnóstico por imagen , Absceso Hepático Amebiano/diagnóstico , Absceso Hepático Amebiano/tratamiento farmacológico , Absceso Hepático Amebiano/microbiología , Absceso Hepático Amebiano/fisiopatología , Masculino , Persona de Mediana Edad , Centros de Atención Terciaria/estadística & datos numéricos , UltrasonografíaRESUMEN
Choroidal osteoma is a rare disease. In this article four case histories were described. All were female and young patient. One patient had bilateral and other three had unilateral involvement. They had no family history. One patient reported at eye department in Bangabandhu Sheikh Mujib Medical University (BSMMU) and the other three patients reported in Bangladesh Eye Hospital. Choroidal osteoma is a benign tumor. It is diagnosed by fundoscopy, ocular B-scan ultrasonography, x-ray orbit, FFA, OCT and CT-scan of orbit. Most patients do not require treatment. Hemorrhage on the lesion suggests the presence of sub-retinal neovascularization which are typically treated with laser or intra-vitreal anti-VEGF.
Asunto(s)
Neoplasias de la Coroides/diagnóstico , Osteoma/diagnóstico , Adulto , Neoplasias de la Coroides/tratamiento farmacológico , Neovascularización Coroidal/complicaciones , Femenino , Humanos , Osteoma/tratamiento farmacológico , Factor A de Crecimiento Endotelial Vascular/antagonistas & inhibidoresRESUMEN
In the frame of a systematic study of charged particle production routes of medically relevant radionuclei, the excitation function for indirect production of (178m)Ta through (nat)Hf(α,xn)(178)W-(178m)Ta nuclear reaction was measured for the first time up to 40 MeV. In parallel, the side reactions (nat)Hf(α,x)(179,177,176,175)W, (183,182,178g,177,176,175)Ta, (179m,177m,175)Hf were also assessed. Stacked foil irradiation technique and γ-ray spectrometry were used. New experimental cross section data for the (nat)Ta(d,xn)(178)W reaction are also reported up to 40 MeV. The measured excitation functions are compared with the results of the ALICE-IPPE, and EMPIRE nuclear reaction model codes and with the TALYS 1.4 based data in the TENDL-2013 library. The thick target yields were deduced and compared with yields of other charged particle ((p,4n), (d,5n) and ((3)He,x)) production routes for (178)W.
RESUMEN
The present study was aimed to find out causes of ascites based on serum-ascites albumin gradient (SAAG) and to compare the diagnostic accuracy of the serum-ascites albumin gradient, proposed as a new biochemical criterion for the differential diagnosis of ascites and to evaluate the value of serum-ascites albumin gradient in differential diagnosis of ascites. This study includes 50 patients with ascites admitted in Medicine wards of Comilla Medical College Hospital, Comilla during the period of July 2010 to June 2011. Blood was drawn from the antecubital vein and ascetic fluid was obtained by paracentesis at the same time. Determination of the concentrations of albumin in both the serum and the ascitic fluid was carried out simultaneously. Considering SAAG value of ≥1.1g/dl is high SAAG and a SAAG value <1.1g/dl is low SAAG. Out of 50 patients, male patients were 36 and female patients were 14. Male and female ratio was 2.5:1. Age range was 21 years to 70 years. Most of the patients fall in age group of 41-50(28%).Among the 50 patients with ascites, cirrhosis of liver accounted for 68%, followed by tubercular peritonitis 12%, nephrotic syndrome 8%, congestive cardiac failure 6%, hepatocellular carcinoma 4% and malignancy related 2%. In this study serum ascites albumin gradient accurately identified the cause of ascites in 97% cases. In contrast the exudate-transudate concept identified only 83% correctly. Serum ascites albumin gradient was found superior to the exudate-transudate concept. So, differential diagnosis of ascites should be based on the serum ascites albumin gradient which is a better distinguishing marker.
Asunto(s)
Ascitis/diagnóstico , Líquido Ascítico/química , Albúmina Sérica/análisis , Adulto , Ascitis/metabolismo , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proteínas/análisisRESUMEN
This prospective, comparative and interventional study was done to compare the effects of Trabeculectomy with Mitomycin-C and medical treatment with Timolol maleate 0.5% by controlling IOP (intra ocular pressure) and assessing the visual acuity (VA) and mean sensitivity (MS) of visual field in moderate stage of steroid induced glaucoma and conducted in the Department of Ophthalmology, Bangabandhu Sheikh Mujib Medical University, Dhaka, from July 2004 to June 2009. Sixty eyes of thirty patients with glaucoma due to use of topical steroids for >1 year. IOP range was 22-30 mm of Hg, visual field with (MD) mean deviation >6 to 12 dB and (MS) mean sensitivity >12-21dB, C:D ratio 0.7-0.8 and visual acuity 6/9 to 6/6 were included in this study. At first, topical steroid was stopped. Sample was collected in lottery method. Patients were divided into two groups. In Group I, 30 eyes were treated with Timolol maleate 0.5%. In Group II, 30 eyes were treated surgically by Trabeculectomy with Mitomycin-C. Follow-up were done on 1st POD, after 7 days, 1 month, 3 months and 6 months. Successful IOP control (<15mm of Hg) were achieved in 23 eyes (77%) in Group I and 30 eyes (100%) in Group II and were highly significant (p<0.001). Visual acuity and mean sensitivity also improved more in Group II than the Group I. It was also highly significant (p<0.001). So, Trabeculectomy with mitomycin-C is effective procedure in comparison to medical treatment for steroid induced glaucoma.
Asunto(s)
Alquilantes/uso terapéutico , Glaucoma/inducido químicamente , Glaucoma/terapia , Presión Intraocular/efectos de los fármacos , Mitomicina/uso terapéutico , Esteroides/efectos adversos , Timolol/uso terapéutico , Trabeculectomía/métodos , Administración Tópica , Adolescente , Adulto , Niño , Terapia Combinada , Femenino , Humanos , Masculino , Estudios Prospectivos , Esteroides/administración & dosificación , Agudeza VisualRESUMEN
Chiral resolution aromatic amino acids, DL-tryptophan (DL-Trp), DL-phenylalanine (DL-Phe), DL-tyrosine (DL-Tyr) from phosphate buffer solution was achieved in present study employing the concept of selective adsorption by surface functionalized magnetic nanoparticles (MNPs). Surfaces of magnetic nanoparticles were functionalized with silica and carboxymethyl-ß-cyclodextrin (CMCD) to investigate their adsorption resolution characteristics. Resolution of enantiomers from racemic mixture was quantified in terms of enantiomeric excess using chromatographic method. The MNPs selectively adsorbed L-enantiomers of DL-Trp, DL-Phe, and DL-Tyr from racemic mixture and enantiomeric excesses (e.e.) were determined as 94%, 73% and 58%, respectively. FTIR studies demonstrated that hydrophobic portion of enantiomer penetrated into hydrophobic cavity of cyclodextrin molecules to form inclusion complex. Furthermore, adsorption site was explored using XPS and it was revealed that amino group at chiral center of the amino acid molecule formed hydrogen bond with secondary hydroxyl group of CMCD molecule and favorability of hydrogen bond formation resulted in selective adsorption of L-enantiomer. Finally, stability constant (K) and Gibbs free energy change (-ΔG°) for inclusion complexation of CMCD with L-/D-enantiomers of amino acids were determined using spectroflurometry in aqueous buffer solution. Higher binding constants were obtained for inclusion complexation of CMCD with L-enantiomers compared to D-enantiomers which stimulated enantioselective properties of CMCD functionalized magnetite silica nanoparticles.
Asunto(s)
Aminoácidos Aromáticos/aislamiento & purificación , Nanopartículas de Magnetita/química , Dióxido de Silicio/química , beta-Ciclodextrinas/química , Adsorción , Aminoácidos Aromáticos/química , Enlace de Hidrógeno , Espectroscopía de Fotoelectrones , Espectroscopía Infrarroja por Transformada de Fourier , EstereoisomerismoRESUMEN
This intervention study conducted in the Neurology outpatient Department of Mymensingh Medical College Hospital (MMCH) from January 2006 to December 2007 to compare efficacy of amitriptyline, pizotifen and propranolol in the prophylaxis of migraine. Ninety cases were selected following certain inclusion and exclusion criteria. Result showed that the differences in duration, frequency and severity of attack were reduced in all groups but the differences among the groups were not significant (p>0.05). However, compared with amitriptyline and pizotifen, the propranolol group needed tablet paracetamol as abortive therapy less frequently which was statistically significant (p<0.05). All the drugs were well tolerated with minimum adverse effects.