No abstract

Background: Despite improvements in antimicrobial therapy, surgical technique and postoperative care, wound infection is still a major concern in pediatric surgical practice particularly in developing countries like Bangladesh. Objective: This study was conducted to ascertain the relationship between the preoperative nutritional status and postoperative wound infection in children as malnutrition is very prevalent among them. It was also decided to estimate the rate of wound infection in children and to identify the indicator of malnutrition that best predicts wound infection. Methods: This prospective study was carried out in the Department of Pediatric Surgery, BSMMU, Dhaka during the period of January 2009 to September 2010 and included consecutive 100 children undergoing routine surgery. Nutritional status was assessed by measuring BMI, serum albumin, haemoglobin and total lymphocyte count and thus children were categorized preoperatively. The children were assessed during the first 30 postoperative days for the evidence of wound infection that were confirmed by culture and sensitivity. Results: We found most of the wound infections among the malnourished children with low BMI and low serum albumin. Conclusion: Preoperative good nutritional status is associated with less postoperative wound infection and BMI and serum albumin are good indicators but total lymphocyte count and haemoglobin are not good indicators of protein calorie malnutrition and serum albumin is the best predictor of wound infection. Journal of Surgical Sciences (2019) Vol. 23(2): 48-53

Aims: The cost of treatment and monitoring of rheumatoid arthritis patients with more effective disease‐modifying drugs like methotrexate and sulphasalazine is prohibitive. This open random clinical trial was carried out with a view to assessing the status of chloroquine, the cheapest disease‐modifying drug, in the treatment of rheumatoid arthritis. Method: A total of 47 cases were included in the study. Thirty subjects were randomly assigned to methotrexate and 14 to chloroquine groups. During 6 months follow‐up, five cases (three in chloroquine and two in methotrexate) dropped out because of side‐effects and inefficacy. Out of the remaining 42, 35 were female and five were male, with a mean age of 46.05 ± 14.12 years. Mean duration of the disease at the time of presentation was 5.53 ± 6.33 years. The two groups did not differ significantly in baseline demographics and disease activity variables. Results: In both groups, most indices showed significant decrease in the disease activity. The difference in decreases in swollen joint count, tender joint count, joint swelling index and duration of morning stiffness were higher in the methotrexate compared to the chloroquine group. Inter‐group differences in the magnitudes of decreases were insignificant in other variables. At the end of 6 months, the response rate, according to the WHO/ILAR criteria, were 75% and 64% in methotrexate and chloroquine groups, respectively. The difference was not significant. Anorexia and nausea were the most common side‐effects in both groups and subsided with the passage of time despite continuation of therapy. Conclusion: Considering low cost and a lesser need for close monitoring, chloroquine may be considered a choice in rheumatoid arthritis patients with mild disease and who are from underprivileged communities.

Introduction: Carpal tunnel syndrome (CTS) may be defined as the compression of the median nerve at the wrist (carpal tunnel) in absence of an obvious injury