Upper GIT Endoscopic Evaluation and Psychological State Assessment of Patients with Globus Sensation.

Globus sensation is a subjective feeling of a lump or foreign body in the throat without interfering swallowing of food. It is a persistent and distressing sensation in throat. It affects about 6% of population. But cause of globus is still unknown. Exact aetiology of globus is considered to be multifactorial. Some other studies also show association between globus and psychological distress including anxiety and depression. As there is no established pharmacological treatment, adequate investigations with negative result could reassure patients and improve their symptoms. In this prospective study consecutive patients with globus symptoms examined by upper GIT endoscopy with attention to larynx, epiglottis, base of tongue, both pyriform fossa and hypo-pharynx using Olympus forward viewing video Gastroscope (GIF Q-150 & GIF Q-170) to exclude organic lesion and was conducted in the department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University (BSMMU) and North East Medical College, Sylhet from 1st July 2014 to 31 December 2016. Their psychological status and epidemiological information including personal and family history were noted in a pre-designed data sheet. Total 104 patients were examined, among them definite anxiety was found in 36(34.95%) and borderline feature of anxiety was found in 19(18.44%) and 48(46.60%) were free of anxiety. Incidence of anxiety was significantly higher among females and was more prevalent among housewife, married people and people from rural community. In this series, 13(12.5%) patients had definite depression and 29(27.9%) patients had borderline depression, while 61(59.2%) patients had no feature of depression. Incidence of depression was significantly higher among females, housewife and married people. Organic lesion is rare in patients with globus symptoms. Globus sensation is more common among females. Psychological factors like anxiety and depression are frequently associated with globus sensation.

Comparative study of coronary collaterals in diabetic and nondiabetic patients by angiography.

Myocardial ischaemia is known to be significantly related to the development of coronary collaterals, but there are considerable variations in their formation. The nature of this variability is not well understood. Likewise it remains unclear whether diabetes mellitus. DM has any effect on coronary collaterals. The aim of this study was to evaluate the effect of diabetes mellitus on coronary collaterals. This prospective case- control study was done from January to December 2000 in patients undergoing coronary angiography in National Institute of Cardiovascular Diseases (NICVD), Dhaka, who fulfilled the inclusion criteria of having < or = 75% stenosis in at least one coronary artery. The patients with diabetes having CAD without other modifiable major risk factors (hypertension, smoking, dyslipidaemia) were constituted case study group (n=36) and nondiabetic patients having CAD with those risk factors were constituted control group (n=50). Coronary collaterals were graded according to Rentrope scoring system and the collateral score was calculated by summing the Rentrope number of every patient. There was no statistical difference between patients with and without diabetes in clinical characteristics. The mean number of diseased vessel in DM group 2.6+/-0.6 was higher than that in nondiabetic patients (2.1+/-0.8, P>.05). The mean collateral score was 0.5+/-0.6 in DM group and 1.2+/-1.0 in nondiabetic group. These findings suggest that coronary collateral development is significantly poorer in diabetic than on diabetic patients.

Outcome of patients treated with the endoscopic dacryocystorhinostomy.

DCR allows an abstracted lacrimal drainage system to be drained into the nasal fossa. Since the development of endonasal endoscopic surgical technique, the endonasal approach presents it self as an alternative choice to the conventional external approach as in the former skin scar can be avoided. We performed DCR of 50 cases in endonasal endoscopic approach in Mymensingh Medical Collage Hospital. The age range of patient was found between 7 to 35 years, average 21 & male female ratio was 1:1.5 with follow up to 2.10 years with high success rate. Associated nasal disease correction septoplasty was done in 7 cases. In each & every case silicon tube was introduced & removed after 3 to 6 months. The only complication was periorbital injury in 5 cases, punctal tear in 2 cases and granuloma formation in 2 cases. Overall success rate was 86%.

High ear piercing--a dangerous craze.

Ear piercing is a primitive tradition among the human being. It reflects the culture of many religions, tribes, and communities, predominately adopted by the females. We reported a sixteen years old girl with painful swelling of both pinnas for last one month following piercing the pinna. She was treated locally by general practitioner without significant improvement. On examination frank abscess were detected in both pinna. Under general anesthesia incision drainage and deep curettage was done. She was treated with ciprofloxacin 750 mg 12 hourly for 2 weeks and recovery was uneventful. After one month she developed unsightly cauliflower ear. With this report we want to sensitize our community regards the risk of transmission of needle prick diseases and deformity of pinna following ear piercing

A study of functional endoscopic sinus surgery technique.

Endoscopic sinus surgery has become a widely accepted surgical procedure for the treatment of chronic inflammatory sinus diseases. In our study 100 patients were suffering from polyposis treated by functional endoscopic sinus surgery in MMCH. Out of 100 patients 53 patients were suffering from ethmoidal polyp and 47 patients were suffering from antrochoanal polyp between the ages 7 to 45 years. Among antrochoanal polyp 2 patients were found with inverted papilloma and came with recurrence. 40% of the patients came with a follow up visit up to 1 year. 7 out of 53 cases of ethmoidal patient came with recurrence requiring revision FESS. There was no history of patient suffering from asthma or aspirin intolerance. Overall success rate was observed in 91%. Four patients were found with periorbital haematoma and 5 with fat coming out from orbit due to injury of lamina papyraceae.

An evaluation of follow up program for drug addict patients.

Regular follow-up and monitoring of progress of recovery is the most important aspect of the treatment of an addict. Recovery from drug addiction is a long-term process rather than a single event. A retrospective study on 288 treated patients from the private chamber of a psychiatrist revealed that only 74 (30.32%. Patient came back for follow-up. Among the 74 patients 30 (40.54%) patients dropped out from the program within two weeks and only 18(24.32%) patients continued to attend the program at regular interval up to 3 months. Percentage of relapse was found highest during 3rd to 5th (within 2 months of discharge) follow-up visits. Majority of he patients who discontinued their follow-up program was unmarried and belongs to the lower socio-economic class.

Brief report on Ziprasidone.

Ziprasidone is a new antipsychotic with combined dopamine and serotonin receptor antagonist activity. The initial evidence suggests an effective dosage range of 80-160 mg/day. Clinical trials suggest that the drug is an effective antipsychotic in schizophrenia and schizo-affective disorder with a beneficial effect on negative symptoms and symptoms of depression. The main adverse effects appear to be somnolence (14%) and nausea (10%). Ziprasidone has relatively fewer side effects and yet has at least equivalent efficacy for florid 'positive' symptoms compared to conventional anti psychotics. The additional serotonergic actions deliver further efficacy against 'negative' and affective symptoms of schizophrenia. Reduced effects on cognitive abilities compared to conventional anti psychotics make Ziprasidone more attractive.