Background: Diabetes mellitus is a complex metabolic disorder that affect 1-2 percent of the population. It can give rise to many tissue complications among which foot is particularly vulnerable to circulatory and neurological disorder, so that even minor trauma can lead to ulceration and infection. Methods: Between September 2008 and August 2009, 100 patients were undergone treatment for diabetic foot at department of Surgery, Shaheed Ziaur Rahman Medical College Hospital, Bogra. This study included all the cases of diabetic foot irrespective of age, sex and diabetic status. Results: After 12 weeks treatment 84% of patient were completely recovered, 2% developed abscess, 8% developed ulceration and 6% developed gangrene. Mean age of diabetic patients with foot ulcer is 50-60 years. Out of 100 cases 64% male and 36% female. Maximum number of patient (64%) had foot problems after suffering from diabetes mellitus for a period of 6-10 years. Conclusion: The modalities of treatment of diabetic foot should be selected for each type of pathology depending on the pattern of presentations of diabetic foot. Careful selection of treatment modalities can reduce the rate of diabetic foot complications and improve the quality of life of diabetic patients. Journal of Surgical Sciences (2019) Vol. 23 (1) : 25-28
Aim: This retrospective study was carried out in Jessore Medical College Hospital and Jhenidah District Hospital on different types of female urogenital fistulae to evaluate its aetiological aspect in the present health care scenario of the country. Materials and Methods: Female patients presenting with features of urogenital fistula were evaluated properly and operated through intra-abdominal and vaginal route depending upon the merit of the fistula. Aetiological pattern of the cases was evaluated along with surgical outcome and post-operative complications. Result: Ofthe 28 female urogenital fistulas, 27 (96.43%) were VVF and 1(3.57%) was UVF. Out of 28 cases, 71.42 %( 20patients) were post-hysterectomy complication, 21.42 %( 6 patients) cases resulted from birth trauma and 7.14 %(n=2) cases were post caesarean complication. Trans-abdominal route was used for operation in 22 (78.56%) cases while 6 (21.42%) cases were operated through trans-vaginal route. In this series of 28 cases, 89.29 %( 25 cases) patients were fully cured and10.71 %( 3cases) patients experienced recurrence. Conclusion: The aetiological pattern of the female urogenital fistula in our country has changed substantially from the dominance of birth trauma to post hysterectomy indicating a remarkable improvement in maternal care system along with development of other socioeconomic parameters. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.71-75
Background: Urolithiasis may be associated with various degree of renal impairment secondaryto a combination of obstruction, urinary infection, long standing calculus, stone burden,frequent surgical intervention, and co-existing medical diseases. Objective: The purpose of the study is to predict the factors those have a significant impact foroutcome of the patients with renal impairment following treatment of urolithiasis. Methods: Fifty patients of urolithiasis with renal impairment were enrolled in this prospectivestudy, carried out between 1st July, 2008 and 30th June, 2009, at department of Surgery,Shaheed Ziaur Rahman Medical College Hospital, Bogra. Patients with renal impairment wasdefined as a baseline serum creatinine of >1.2mg/dl and/or on the basis of DTPA isotoperenogram findings (mild, moderate or severe impairment). Definite management was carriedout by means of open surgery, ESWL or in combinations available at study place. Follow-up after3 months, the postoperative renal functional outcome was defined as improved (>20% fall inserum creatinine), stabilized (<20% rise or <20% fall in serum creatinine), or deteriorated(>20% rise in serum creatinine). Renal function was also assessed by the impression madefrom the graph of DTPA isotope renogram (normal functioning or mild, moderate and severeimpairment). Predictive factors to be evaluated for the stone clearance and renal functionaloutcome were age of the patients, duration of symptomatology and urolithiasis, associateddiseases (hypertension and diabetes mellitus), stone burden, stone number and associatedurinary infection. Results: After 3 months of follow-up, the overall stone clearance rate was 76%. Out of 50patients, 27 patients (54%) showed improvement, 19 patients (38%) showed stabilization, and04 patients (08%) showed deterioration in their renal function. Age <40 years, duration ofsymptoms <6 months, stone burden <5 cm2 and single urinary stone were significant predictorsof subsequent good renal functional outcome. Conclusion: The renal recoverability rate after treatment of urinary stone disease could bepredicted by age, duration of symptoms, stone burden and stone number Journal of Surgical Sciences (2016) Vol. 20 (1) : 18-23
Background: Renal calculi are common approximately 50% of patient between the ages of 30and 50 years. The development of endourological and extracorporeal lithotripsy techniques ledto an increasing number of options for the management of renal calculi. Objective: To define factors those have a significant impact on the success rate after extracorporealshock wave lithotripsy (ESWL) for treatment of renal stones. Materials and Methods: Between April 2008 & December 2008, 64 patients with single ormultiple radiopaque renal stones (::s;30mm) were treated with ESWL monotherapy using StortzModulith SLX-F2 lithotriptor.The results of treatment were evaluated after 3 months of followupTreatment success was defined as complete clearance of the stones or presence ofclinically insignificant residual fragments (::s;4mm).The results of treatment were correlated withthe patient characteristics (age, sex, body mass index) and stone features (size, site, nature &radio density). Results: At 3-months follow-up, the overall success rate is 76%. Among them, repeated ESWLsessions are required in 19 patients (53.9%). Post-ESWL complications are recorded in 8patients (12.5%). Using the x2 test, only three factors have a significant impact on the successrate, namely: stone site, size (the largest diameter of the stone), stone number & BMI (BodyMass Index). The success rate is highest for stones located in the upper calyx (15/15; 100%)and lowest for those located in the lower calyx (10/16; 62.5%) (p=.005). Stones with a largestdiameter ot s 15mm are associated with a success rate of 90.2% (37 /41), compared to 52.2%(12/23) for those with a diameter of >15mm (p=.001). The success rate is also higher forsingle stone (46/56; 82%) than multiple stones (3/8; 37.5%) (p=0.005).Patients with lowerBMI (<24) have a better success than higher BMI (>25) (p=0.01) Conclusion: The success rate of ESWL for the treatment of renal stones can be predicted bystone size, location, number and patient BMI. Journal of Surgical Sciences (2016) Vol. 20 (2) :46-50
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