In the treatment of common bile duct stones and palliative decompression of malignant strictures, endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard. However, there are still concerns about procedure-related complications and patient discomfort. The aim of the study is to evaluate the pattern of post ERCP complications. This prospective observational study was conducted at the Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from February to October 2017. A total of one hundred patients who were eligible for ERCP were included in this study but five patients were excluded due to cannulation failure. Clinical examination , biochemical, and radiological investigation were performed before and after ERCP to assess the complication that occurred. The majority of patients in this study were at and below the age of 50 years, with a mean age of 49.74 ± 14.07 years and the age range was between 18 to 80 years. Majority of the subjects were male (54.7%), and male to female ratio was 1.21:1. The highest number of patients were diagnosed as choledocholithiasis (58.9%) followed by proximal cholangiocarcinoma (13.7%), Ca-gallbladder with biliary infiltration (8.4%), Distal cholangiocarcinoma (6.3%), Chronic calcific pancreatitis and Periampullary carcinoma each (3.2%), Suspected SOD & Chronic pancreatitis each (2.1%) and Worm in CBD and benign biliary stricture each (1.1%). In this study, the overall post-ERCP complication was 12.6%, with pancreatitis accounting for 9.4%, bleeding accounting for 2.1%, and cholangitis accounting for 2.1%. From the study, it can be concluded that pancreatitis is the most frequent Post-ERCP complication. Bangladesh Med J. 2021 May; 50(2) : 35-39
Histoplasmosis is underreported although in Southeast Asia including Bangladesh is thought to be endemic considering the favorable geo-climatic conditions for the organism. Non-recognition of histoplasmosis is particularly attributed to possible misdiagnosis as tuberculosis (which is endemic here and common in Bangladesh) because histoplasmosis mimics tuberculosis in clinical presentation, imaging and histopathology. Disseminated histoplasmosis mainly occur in immunocompromised patients and rare in immunocompetent subjects. Here we are reporting two cases of disseminated histoplasmosis where both were immunocompetent and presented with FUO. Both patients visited several health centers before coming to us with no definite diagnosis and we got them in a progressive stage. Both were confirmed through bone marrow study. Unfortunately, one of them died from disease progression, sepsis and other complications and another patient gradually improved with treatment (amphotericin B and itraconazole). We are reporting these cases to highlight the fact that disseminated histoplasmosis does occur in immunocompetent patient and may occur with or without pulmonary symptoms. A high index of suspicion is required for diagnosis and delay can often be fatal. J MEDICINE 2023; 24: 59-64
Background: The aim and objective of this study was to compare the effectiveness between mannitol and sodium phosphate as a colonoscopic bowel cleansing agent conducted in the department of Gastroenterology of Sir Salimullah Medical College Mitford Hospital. Methods: In this cross-sectional study, a total number of 108 cases were randomly selected, who underwent colonoscopy from November 2019 to June 2020 in the department of Gastroenterology of Sir Salimullah Medical College and Mitford Hospital. The patients were divided into two groups based on received bowel preparations agent, either mannitol (Group MN) or sodium phosphate (group NaP). Results: Out of 108 patients 57 received mannitol and 51 received sodium phosphate. Thirty-two males and twenty-two females received mannitol, while 28 males and 23 females received sodium phosphate. Excellent bowel preparation was observed in 32(55%) cases of MN group and 26(45%) cases of group NaP. No statistically significant difference between two groups by Chi-square (X2) test (p=0.793). Conclusion: This cross-sectional, randomized study did not show any significant statistical difference between the two agents regarding effectiveness of bowel preparation. So, both mannitol and sodium phosphate are almost equally effective in achieving excellent or good quality of bowel preparation. Bangladesh J Medicine 2022; 33: 263-268
In the treatment of common bile duct stones and palliative decompression of malignant strictures, endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard. However, there are still concerns about procedure-related complications and patient discom- fort. To evaluate the pattern of the post ERCP complications. This prospective observational study was conducted at the Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from February 2017 to October 2017. A total of one hundred patients who were eligible for ERCP were included in this study but five patients were excluded due to cannulation failure. Clinical examination , biochemical, and radiological investigation were performed before and after ERCP to assess the complication that occurred. The majority of patients in this study were under the age of 50, with a mean age of 49.74 }14.07 years between the ages of 18 and 80 years. Males (54.7%) were predominant than female (45.3%) and male to female ratio was 1.21:1. The most common diagnosis was choledocholithiasis (58.9%) followed by proximal cholangiocarcinoma (13.7%), Carcinoma-gallbladder with biliary infiltration (8.4%), Distal cholangiocarcinoma (6.3%), Chronic calcific pancreatitis and Periampullary carcinoma each (3.2%), Suspected SOD & Chronic pancreatitis each (2.1%) and Worm in CBD and benign biliary stricture each (1.1%). In this study, the overall post-ERCP complication rate was 12.6% with pancreatitis accounting for 9.4%, bleeding accounting for 2.1%, and cholangitis accounting for 2.1%. From the study data it can be concluded that pancreatitis is the most frequent Post-ERCP complication. BSMMU J 2022; 15(1): 50-53
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