Background and Objective: Currently, laparoscopic appendectomy (LA) is widely practiced for the management of acute appendicitis (AA). The application of laparoscopic technique for appendectomy is expanding very rapidly and now performed in almost all major cities and tertiary level hospitals. This study addressed to determine the outcomes of laparoscopic appendectomy in our surgical setup at Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorder (BIRDEM).
Background: Fourniers gangrene is the necrotising fasciitis of the genitalia and perineum, with associated poly microbial infection. Evidence based data in the very recent years suggest that it is associated with significant and potential risk of organ failure or death.Aim: This study was designed to be conducted among the patients suffering from Fourniers gangrene with a view to assess the probable prevalence rate of potentially adverse clinical consequences during course of treatment, overall mortality and to observe the microbiological pattern in our surgical practice.Method & materials: This cross sectional study was conducted among the 69 patients of Fourniers gangrene in BIRDEM General Hospital, Dhaka, Bangladesh from Jan 10.2013 to Sept 01 .2016, using the purposive sampling method.Results: The results of this study reflects that majority (43.4%) of the study population were in 51 to 60 years age group( Mean age 43±1.7 years) in study population. By using the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score, it was found that in most of the patients (approx 56.5%), a suspicious score ranging 06-08 was observed and only in 10.1% patients, a specific score of ?08 was observed. In 27.5% patients systemic complications like DIC, ARDS, MODS, MSOF and severe sepsis were observed in 1.4%, 4.3%, 10.1%, 4.3% and 5.7% cases respectively. Mortality rate was approximately 4.3%. Majority (84.1%) of the patients were associated with type 1 (Polymicrobial) bacterial infection, whereas in case of 15.9% patients, it was associated with type 2 (Monomicrobial) infection. Escherichia coli was the most frequently observed micro-organisms associated with approximately 39.1% of all cases. S. aureus, Staphylococcus pyogenes, Enterococci species, E.coli and Pseudomonas species were recorded to be associated with 17.4%, 27.5%, 21.7%, 39.1 and 10.1% cases respectively.Conclusion: This study suggests that Fourniers gangrene is associated with significant systemic complications. Poly microbial infections are most predominant and E coli infection was commonest organism involved.Bangladesh Crit Care J March 2017; 5(1): 28-32
Background: Evidence based data in the very recent years suggest that in spite of tremendous advances in contemporary anaesthetic practice and advances, airway management continue to be of paramount importance to anaesthesiologists and data regarding the outcomes of use of LMA (laryngeal mask airway) in contrast to ETT (endotracheal tube) are scanty in our clinical setup. Aims & Objectives: In this RCT (Randomized Control Clinical Trial), the ultimate aim was to depict the anaesthetic safety and haemodynamic changes of use of LMA in contrast to ETT for the patients of routine laparoscopic cholecystectomy (ASA II & III). Methods and Materials: This randomized control clinical trial (RCT) was conducted in BIRDEM General Hospital, Dhaka, Bangladesh with a total number of 60 patients (30 patients with endotracheal tube & 30 patients with LMA) were selected on the basis of systemic random sampling. The haemodynamic changes, oxygenation, ventilation and intraoperative and postoperative laryngopharyngeal complication (LPM) were noted. Results: The ultimate result of this study suggest that in Group A (ETT group), mean±SD of age was 48±1.9 and in Group B (LMA group), it was 52±1.7. Demographic status suggests that the average BMI in both group were 28.9 and 30.6 respectively. In ETT group, majority of patients (69%) had ASA grade II, in contrast, in LMA group, it was 52%. Average anaesthetic duration in both group were 45 & 50 minutes respectively. There found significant difference in haemodynamic parameter during Intubation and LMA insertion. There were no statistically significant differences in oxygen saturation (SpO2) between the two groups before or during peritoneal insufflation. Laryngeal complications, like coughing and vomiting following removal of tube were found in 6.7% and 3.3% patients respectively with the use of LMA. No case of tube leak, gastric insufflation, regurgitation, aspiration, trauma to lip, teeth, tongue, dysphagia, dysphonia and dysarthia was recorded. P-values suggests statistically insignificant result here (>0.05). Conclusion: The effectiveness and safety of LMA in terms of intra and postoperative haemodynamic status, SaO2 and laryngeal complications are clinically comparable to those of endotracheal tube. And LMA insertion causes less changes of haemodynamic parameters when compared with that of ET intubation. Our finding suggests that LMA can be safe and beneficial alternative to ETT. JBSA 2017; 30(1): 34-40
Background: Foot infections are one of the major complications of diabetes mellitus and are significant risk factors for lower extremity amputation. Providing effective antimicrobial therapy is an important component in treating these infections, which requires information about pattern of bacterial growth and their antibiotic susceptibility. This study was designed to investigate the microbial pattern of diabetic foot infections and their antibiotic susceptibility. Methodology: This prospective study was conducted in Surgery Unit 1 of Bangladesh Institute of Research and Development in Endocrine & Metabolism (BIRDEM) General Hospital, Dhaka, Bangladesh from September, 2013 to November 2016. A total 81 diabetic patients of infected chronic foot ulcer were selected on the basis of convenient sampling. Data were collected on demographic characteristics (age and sex), examination findings, bacterial involvement, its type and sensitivity pattern. Wagner’s ulcer grading system was used to classify the chronic foot ulcers Result: The age distribution of the sampled population depicted that over half [42(51.8%) out 81] of the patients was in their 5th decade of life. Females were slightly higher (53.1%) than the males (46.9%) with mean ages of the male and female patients being 48.0 ±1.5 and 53.0 ±1.2 respectively. Based on Wagner ulcer grading system, 45.7% of the foot ulcers were grade II followed by 21.0% grade III, 13.6% grade IV, another 13.6% grade I and only 6.2% grade 0. Most of the infections were polymicrobial (88.9%) and isolated micro-organisms were frequently E. coli (47.1%) and Klebsiella (33.3%). The antibiotics sensitivity against the micro-organisms demonstrated that colostin was the most sensitive antibiotics (97.5% of all cases), followed by imipenem (90.1%) and meropenem (90.1%). Conclusion: Chronic foot ulcers in diabetic patients are usually associated with polymicrobial infection. E. coli, Klebsiella and Pseudomonas are the most common micro-organisms isolated, which are sensitive to colostin, imipenem and meropenem in majority of the cases. Ibrahim Card Med J 2016; 6 (1&2): 51-55
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.