Introduction: Dog bites in humans are a major public health problem. Globally, millions of people are bitten by dogs but most of the fatal cases occur in children. Dog bites in human are a serious public health problem and have been well documented worldwide. As rabies is not a notifiable disease in Bangladesh and most deaths occur in rural areas where surveillance is poor. Objectives: To determine the pattern of dog bite injuries and associated health problems among children. Methods: The study was an observational retrospective study carried out at the Dept. of General Surgery, Chuadanga Sadar Hospital, Chuadanga, Bangladesh. The study reviewed the clinical data of patients managed for dog bite related injuries and rabies over a four and half year period between January 2016 and June 2020. A proforma was designed to extract relevant clinical data from the case records. Information extracted included the age, sex of the victims, site of the bite, time of presentation in the hospital, pre-hospital treatment, hospital treatment including post-exposure prophylaxis and complication. Results: In all, 200 cases of dog bite injuries were managed constituting 0.89% of the total consultations; 5 (2.5%) had rabies. Most of the victims were aged 6-12 years (55.0%) and majority (67.0%) was boys. Eighty two percent of the victims presented within 24hrs of the injury. 92 (46.0%) had WHO grade 3 dog bite injury at presentation and the lower limb was the commonest (56.0%) bite site. Use of herbal preparation was the most common pre-hospital treatment 60%. Although 95.0% received anti-rabies vaccine, only 55.5% of them completed the vaccination schedule. The case fatality rate for dog bite was 5.0%. The 5 that died all presented late, had no post exposure prophylaxis and died within 24 hours of admission. Conclusion: There is need for public enlightenment on dangers associated with dog bites and also for the government to ensure vaccination for cost of post exposure prophylaxis treatment for children free of cost
Background: There are versatile operative techniques for treating complete rectal prolapse. Every procedure has some advantages and disadvantages. Delorme’s procedure and abdominal rectopexy (Well’s procedure) have gained more popularity. But to determine which approach is better, it is needed to evaluate the functional outcome of both procedures. Objective: To compare the outcome of Delorme’s procedure and abdominal rectopexy to treat complete rectal prolapse. Methodology: A randomized control trial was conducted in 25 patients with complete rectal prolapse in the department of Surgery, RMCH. They were divided into two groups by randomization. Fifteen patients included in Group-I underwent Delorme’s procedure, and ten patients included in group-II underwent abdominal rectopexy (Well’s procedure). The outcome of both procedures was compared postoperatively. Results: In group-1, we have found uneventful outcomes of 10 (66.66%) patients, and hemorrhage, minor incontinence, and retention of urine were found in 2(13.3%), 1(6.66), and 4(26.66%) patients, respectively. In group-2 patients, 5(50%) patients recovered uneventfully, whereas hemorrhage, surgical site infection, retention of urine, bladder dysfunction, and constipation were found in 2(20%), 1(10%), 1(10%), 1(10%) and 2(20%) patients respectively. The mean operation time in group-I was 92.86 min and in Group 2 was 124.00 min with a p-value of 0.001. The average post-operative hospital stay after Delorme’s procedure was <4 days in 4 patients and 4-6 days in the rest 11 patients. But the hospital stay is a little lengthier in the case of abdominal rectopexy (Well’s procedure), where seven patients were discharged within 4-6 days, and three patients were discharged after the 5th day of operation. In group I, expenditure was <7000 taka in 10 (66.66%) patients, whereas in group-2 , the cost was 10000-15000 in 7(70%) patients with a p-value of 0.001. Conclusion: We can conclude that Delorme’s procedure is comparatively safer and cost-effective than Well’s procedure, considering different vital parameters. TAJ 2021; 34: No-1: 40-46
Abdominal wall hernias are frequently encountered in surgical practice accounting for 15% - 18% of all surgical procedures. Worldwide, more than 20 million hernias are operated per year. Lifetime risk of developing inguinal hernia is 15% - 27% in men and 3% in women. Itscommonly performed general surgical procedure that constitute more than 95% of all groin hernia repairs. However, in developing countries, quite a considerable percentage of it is not repaired or delayed repaired and that lead to a higher incidence of morbidity and mortality. Objective: To evaluate the clinical, epidemiological profile and associated risk factors for inguinal hernia. Methodology: This observational study was conducted among 100 patients during March 2019 to March 2020 who admitted in the surgery department of a General Surgeryfor inguinal hernia surgery. All the study subjects were examined and their clinical and epidemiological profiles studied, tabulated and analyzed. Results: Among the 100 patients, most of them (94%) were men with an age of 57.02 ± 12.87, farmer (36%) by occupation.61% patients were in low sacio-ecenomic status. Most of the patients (60%) were in the age group of 40-60 years followed by less than 30 years (21%). on query regarding symptoms of inguinal hernia, all of them (100%) complaints of groin swelling. more than half of the patients complaints of groin pain and sensation of heaviness in groin. On clinical examination, right sided, left sided, bilateral hernias were found in 49%, 45% and 6% study patients respectively. Direct hernias, indirect, pantaloons hernias were seen in57%, 30%, 7% study patient respectly. Most of hernias (81%) were reducible and were incomplete (88%). Most of the patients (75%) presented late to the health care center due to the lack of awareness of the disease and were initially treated by homeopath medicine. During query about risk factors for inguinal hernia, 46% patients were more than 50 years of age and 26% patients were smoker. Total open procedure was 93% and laparoscopic hernia repairs were done only in 7% patients. Conclusion: In this study, we found that male are more affected than male. Right sided and direct hernia is more common. Most of the patients from low socio-ecenomic condition and main risk factors are old age, smoking, lifting heavy objects prostatism and constipation. Most common hernia repair procedure were Lichtensteinsprocedure.
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