Background: Snake bite is an important health hazard which may lead to fatality in rural areas of Bangladesh. An epidemiological study estimated the incidence of snake bite in Bangladesh about 8,000 per year with 22% mortality. In majority of cases the victims die before entrance to hospital because of their treatment seeking behavior from Ohzas. Present study is to see the clinical profile of snake bite cases admitted in Dhaka Medical College Hospital and also to find out problems in diagnosis and management and outcomes. Methods: Fifty patients of snake bites treated in Dhaka Medical College Hospital, Dhaka, Bangladesh between July 2005 and December 2006 were studied. A questionnaire, containing information on bite, physical examination and identification of snake brought was used. Results: Among the patients venomous snake was 6 (50%) with cobra and 6 (50%) with suspected krait bite. Males were bitten more frequently than females 42(82%) versus 9(18%). Regarding occupation, 28 (56%) was farmer. Majority 37(74%) came from rural areas. Highest number of bite occurred in evening 20(40%). Most snake bite occurred during rural foot walking (30%) followed by sleeping (14%).Total 54% of bite occurred during outdoor activities. Most common site of bite is lower limb 35(70%). Tight tourniquet used in 45(90%) cases and in 8(16%) cases limb was immobilized. Twenty eight (56%) of the patients received treatment from Ohzas. All venomous bites (12) presented with features of neurotoxicity with local envenoming in 6(50%) cases. In 6(50%) cases there were only neuroparalysis. Four (33.34 % of venomous snake) patients required respiratory support and 10(83% of venomous bite) patients required antivenom. There were no anaphylactic reactions and only 2 patients suffered pyrogenic reaction. The outcome was excellent with only one death and only one case of residual effects. Conclusion: To develop an appropriate prevention and control strategy, reliable and timely information has a crucial role. A functional mechanism should be developed to gather information not only about the cases and deaths but other aspects of the snakebite epidemiology.
Introduction : Diabetes Mellitus is a multifactorial disease, associated with a number of micro vascular (Retinopathy, Neuropathy and Nephropathy) and macro vascular (Ischemic Heart Disease, Cerebrovascular Disease and Peripheral Vascular Diseases) complications. Duration of diabetes, current smoking and presence of co morbidities such as HTN, IHD all are significantly associated with the ocular complications in this study. Objective: The purpose of the study is to see the glycaemic status and co morbidities influencing the ocular complications. Methods: The patients for the study were randomly recruited from the Eye outpatient clinics in Chattagram Maa Shishu-O-General Hospital, Chittagong, Bangladesh, from July 2014 to October 2014. Risk factors of DR like age, sex, duration of diabetes and hypertension, IHD, smoking status were evaluated. Results: The study showed that 53 are male and 47 are female. Maximum age is 85 and minimum age is studied at 28. Cataract was the predominant complications presented our study. 22% patient had unilateral and 20% had bilateral cataract. 29% had retinopathy. Mean FPG , PPG & HBA1c levels in unilateral cataract were 7.0 mmol/L, 8.9 mmol/L and 7.03 mmol/L in comparative to retinopathy group was 8.4 mmol/L, 10.6 mmol/L and 8.6 mmol/L respectively. Major complications are retinopathy are found in 26% hypertensive and 24% IHD patients, prevalence of Diabetic retinopathy is 6.9% after 5 years onset of DM and 73.9% after 15 years of diabetes. Conclusion : Prevalence of Diabetic ocular complications is high in our country, Ocular complications increases proportionately to duration and presence of co morbidities. Tight control of DM and periodic eye examination can prevent complications.
It is a prospective study is done with materials of 100 cases of Tonsillectomy patient giving Proper attention to age, sex, Indication of operation, Clinical Presentation, Duration of Operation ,Post operative complications. Altogether 100 Patients of whom 54 were male and 46 female, collected for a period of 6 months from 16 th July 2001 to 15 th January 2002 with maximum age group 48% were of 20+years and a sex ratio of Male: female 1.17:1 were included in the series the commonest indication is Recurrent tonsillitis was 83%. Among them clinical presentation, Patients presented with recurrent pain in throat (85%), History of Fever in 62% and difficulty in swallowing in 46%. Regarding duration of operation 40% Patients were operation within 30 to 39 minutes, 31% patients were operated within 40 to 49 minutes. In this Series, Complications that encountered after operation were hemorrhages both reactionary and secondary 1% and 2% respectively, operative local trauma in 4% cases and local infection in tonsillar bed in 6% cases .In this Series one patient needed second time general anaesthesia.
Background: Chronic kidney disease (CKD) is an important public health problem. Renal replacement therapy (RRT) is needed to patients who goes to end stage renal disease(ESRD). Most of the evidence on its costs relates to patients receiving dialysis or kidney trans-plants, which shows that, in these phases, CKD poses a high burden to payers. The aim of this study was to estimate the financial burden of patients with CKD on maintenance hemodialysis. Methods: It is one -year observational study, carried out to collect data on 105 patients with CKD on dialysis taking from different centers of Chittagong Bangladesh. After collection of sociodemographic informations financial status were collected from patients who gave informed written consent to be included in the study. Data were analyzed by SPSS 20. Results: Regarding gender distribution, male was 73(69.5%) and female was 32(30.5%). Male to female ratio was 2.28:1. Age group distribution revealed 10(9.5%) patients were at <30 years, 18(17.1%) were at 31- 40 years, 23( 21.9%) were at 41-50 years, 26(24.8%) were at 51-60 years, 20(19.0%) were at 61-70 years and 8(7.6%) were >71 years age. Among all most were involved in service 40(38.1%) and business 23(21.9%). Socio economic status of the patients revealed 42(40.0%) patients were from upper middle class, 50(47.6%) were from lower middle class. Among all, 33(31.4%) patients took treatment from abroad. Regarding bearing of cost of the dialysis 24(22.9%) were self financed and 35(33.3%) got help from others(non family member), 11(10.5%) took loan and 13(12.4%) sold their stable land property. Regarding tenure of dialysis 31(29.5% patients are getting dialysis <1 year and 74(70.5%) were getting it for 1-2 years. Previous monthly income before start of dialysis was zero(0) in 33(31.4%) patients and it was >30000 taka/month in 34(32.4%) patients and after start of dialysis present monthly income was zero(o) per month in 67(63.8%) patients and >30000 taka/month in 13(12.4%) patients. Regarding expenditure for each dialysis showed 2(1.9%) had zero(0) taka and 46(43.8%) patients needed 1000-2000 taka/session and 41(39.0%) needed 2000-3000 taka /session. Conclusion: Dialysis in CKD patients is a huge financial burden to the patients himself and the family. Government assistance should be provided to all patients who are unable to bear the cost.
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