Objective: Aim of our study is to analyze the surgical outcome of total laparoscopic hysterectomy (TLH) in our patient perspective of Apollo Hospitals Dhaka.Methods: This is a retrospective, observational study where we have reviewed demographic data, intraoperative and postoperative outcomes, and morbidity data on 100 women who underwent TLH between January 2011 and December 2012.Results: Total 100 patients were studied. Among them five patient required conversion to laparotomy due to presence of severe adhesion. The major and minor complication rates were 2% (bladder injury-2 cases) and 0% respectively. The average operating time was 148 ± 40 minutes and the mean length of hospital stay was 3±1 day. The average uterine size was 10 ± 4 weeks. In our cases operating time and duration of hospital stay were very similar with lower procedural complications to other published data elsewhere.Conclusion: We have observed that TLH is a safe and acceptable alternative procedure to standard hysterectomy from the patients perspective at Apollo Hospital Dhaka.Pulse Vol.8 January-December 2015 p.21-29
Background: Methotrexate (MTX) is widely used in the treatment of Rheumatoid arthritis (RA) as first line disease modifying anti-rheumatoid drug. Low dose MTX may reduce lung function status in RA patients.Objective: To observe the changes in large airway ventilatory variables in RA patients after MTX therapy.Methods: For this prospective observational study, 24 female RA patients of age ranges between 15 to 65 years were selected from the Out-Patient Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University, Dhaka. Age and BMI matched 24 apparently healthy females were also selected Control. To assess the large airway ventilatory function, FVC, FEV1, FEV1/ FVC% and PEFR of all subjects were measured with a portable digital Spirometer, PONY FX (Cosmed, Italy) at Day 0. In addition, all these variables were again measured in the RA patients after 180 days of MTX therapy. For statistical analysis, independent sample t test and paired sample t test were performed.Results: All the study variables (except FEV1/FVC%) were significantly (p<0.001) lower in RA groups at day 0 as well as at day 180, compared to healthy controls. Again all these variables were almost similar in the RA patients at day 180 when compared to those of day 0.Conclusion: Large airway ventilatory function deteriorated in RA patients, which may not be recovered by six months methotraxate therapy.J Bangladesh Soc Physiol. 2018, June; 13(1): 35-40
Background & Objective: Dengue is an important tropical infection caused by an arbovirus having four serotypes (DENV-1, DENV-2, DENV-3, DENV-4) transmitted through the bite of infected female Aedes mosquito. Dengue is a challenging disease with multisystemic, varied, atypical, and sometimes life-threatening presentations. It presents as varied clinical spectrum of dengue fever (DF), dengue hemorrhagic fever (DHF), dengue shock syndrome (DSS) and expanded dengue syndrome (EDS) with atypical presentations, thus posing a diagnostic dilemma. Each year, thousands of dengue infections are reported and there are several outbreaks of dengue in several countries including Bangladesh and this imply the global importance of this infection. The objectives of this study were to determine the sociodemographic variables, presenting complaints and clinical findings of patient suffering from dengue fever during an epidemic outbreak. Methods: This hospital review analyzed the hospital records of dengue fever cases of BIRDEM General Hospital, Dhaka from June 2019 to December2019. Patients with suspected dengue fever attending at the outdoor/emergency or admitted indoor were taken as case. Data was collected from hospital records. Study protocol was approved by the Institutional Review Board and informed consent was taken from the subjects. All the relevant data regarding history and examination findings of the patients, the laboratory reports were collected. Statistical package for social science (SPSS) version 22, a computer-based software was used for all data entry and statistical analysis. Results: Total 292 dengue patients were enrolled in this study. Mean age of all patient was 35.63±15.22 years (11-85 year) with male predominance (54.8%). Maximum patients were hailed from urban residence (83.9%), non-smoker (73.6%), had active lifestyle (63.4%) and normal body mass index (68.5%). Overall, 65.1% patients had no comorbidity and 89.4% had no concurrent acute illness.Majority of the patients had high grade fever (76%) for 2-5 days (71%). Bodyache (63.7%), headache (42.1%), vomiting (41.1%), loose motion (16.8%) and abdominal pain (14.7%) were the top five chief complaints along with fever. Most of the patients had normal systolic (86.3%) and diastolic (92.5%) blood pressure. Conclusion: Although the results of this study cannot be generalized to other cities of Bangladesh, our findings will allow public health agencies in Bangladesh to concentrate their efforts to battle dengue and also suggests that monitoring where Aedes are found will help identify populations at risk". Our study will guide doctors of all level to early diagnose dengue patient and will help them to detect the severe cases early. So that early intervention can decrease the morbidity and mortality.
Obstructive Sleep Apnea (OSA) is a serious common sleep disorder needs life long care. OSA is caused by recurrentupper airway obstruction due to increased upper airway collapsibility during sleep. It is highly associated with obesitywith several endocrine and metabolic diseases. Hypothyroidism may cause OSA, also linked with obesity. Obesity isalso a risk factor for hypertension.This paper is presenting a case of obstructive sleep apnea with obesity, hypertensionand hypothyroidism. A 35 years old male presented with the complaints of excessive day time sleepiness, loud snoring,fragmented sleep, apnea like attack, occasional morning headache. Whole night polysomnography was done anddiagnosed as severe obstructive sleep apnea. At therapeutic part of polysomnography, he was treated with BiPAP. BangladeshCrit Care J September 2019; 7(2): 109-110
Narcolepsy is a sleep disorder presented with excessive sleepiness. Excessive sleepiness is key symptom of Narcolepsy. In obstructive sleep apnea excessive daytime sleepiness is also a remarkable symptom. Here we presented a 67-year-old female with uncontrollable sleep attacks and hypnagogic hallucination. She was previously diagnosed as obstructive sleep apnea and under BiPAP therapy for last few years. Her multiple sleep latency test become positive to meet diagnostic criteria for Narcolepsy. Clinicians should be cautious about possibilities of coexisting sleep disorders like Narcolepsy and obstructive sleep apnea in excessive day time sleepiness complaining patients. Bangladesh Crit Care J September 2022; 10(2): 161-162
Background: Nutritional rickets has emerged as a public health problem in Bangladesh during the past two decades, with up to 8% of children being clinically affected in some areas. Insufficiency of vitamin D and dietary calcium is thought to be the underlying cause. Vitamin D administered with or without calcium is commonly regarded as the mainstay of treatment. Calcium alone or in combination with vitamin D has also been used in the treatment of nutritional rickets. So this study was done to assess the effects of vitamin D, calcium or combination of vitamin D and calcium for the treatment of nutritional rickets in Bangladeshi children. Methods: This open labeled randomized comparative study was done in the Department of Paediatrics, Sylhet MAG Osmani Medical College Hospital from July 1, 2010 to June 30, 2012 A total 48 rickets patient was enrolled in this study. After selection of cases patients were divided in to three groups by lottery method. Group A received single i/m dose of vitamin D 4,00,000 IU (2,00,000 IU in each buttock), Group B received calcium (750 mg per day) for 6 weeks and Group C received both calcium (750 mg per day) for 6 weeks and single i/m dose of vitamin D 4,00,000 IU (2,00,000 IU in each buttock). Response was evaluated by serum alkaline phosphatase level and using 10-point radiographic score developed by Thacher and colleagues at baseline, 6 weeks, and 12 weeks. Results: Mean age of the study participants was 35.83 months. Male to female ratio was 2:1. The radiographic score was significantly improved in first and second follow up (p<0.001) in all groups. But there was significant difference of improvement in Group C than Group A and Group B. In Group C, the percent reduction from base to first follow up was 80.05±7.04 and 90.65±3 in second follow up which showed quick improvement in combination therapy. Serum alkaline phosphatase also significantly reduced in all three groups. Conclusion: Combination use of vitamin D and calcium in the treatment of nutritional rickets is more effective than prescribing either vitamin D or calcium alone. Birdem Med J 2021; 11(1): 39-46
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