Background : The term “Intra-cranial space occupying lesion” (ICSOL) is defined as any neoplasm, benign or malignant, primary or secondary, as well as any inflammatory or parasitic mass lying within the cranial cavity. Advances in intracranial imaging have made the detection of intracranial lesions relatively accurate and enabling us to focus on the etiology of these space-occupying lesions. Many reports suggested that both incidence and pattern of intracranial space occupying lesions are subject to considerable geographic and racial variations. Knowledge of the regional peculiarities of these lesions will help in identifications of possible risk factors. Materials and Methods: This observational study was done in the department of medicine of Mymensingh medical college hospital, Bangladesh from November, 2011 to April, 2012 to evaluate the clinical pattern of ICSOL among the 75 adult admitted patients. Patient aged more than 15 years of either sex with symptoms and signs of ICSOL and at least one CT or MRI evidence in favour of diagnosis were included. Results: The highest participation (22.7%) was observed from 55-64 years age group. Mean age of the participants was 54.35±18.68 years. Neoplastic tumor was (25.8%) in 15-24 years age group and non neoplastic lesion was (31.8%) in 55-64 years age group, among participants (76.0%) came from rural areas and 24% from urban. Population regarding the occupation 30.7% were housewives, 21.3% were service holders and 20.0% are farmers. Headache was the most common symptom noted in 93.33% of patients. Nausea/ vomiting, difficulty in limb movement and imbalance were the other most common three symptoms. In this series intracerebral hemorrhage was found in 53.3% of patients, Astrocytoma was the second most common (20.0%). Meningioma was found in 8% of the participants and another 8% had metastatic lesions in their brain. There were two cases of schwanoma while tuberculoma was diagnosed in another two participants (2.7%). Conclusion: Patients with symptoms and signs of ICSOL should be dealt with great care and CT or MRI helps to evaluate them for early diagnosis and proper management. J Dhaka Medical College, Vol. 28, No.1, April, 2019, Page 17-22
Background: Post-operative outcomes of a major abdominal surgery depend on careful & effective post-operative management. But it is a critical job especially in children. Obtaining adequate analgesia after major surgery is a problematic issue and postoperative pain still imposes a major burden of suffering in surgical patients.Objectives: The principle objectives of the study is to evaluate the effects of intravenous lidocaine infusion in pain management of pediatric population undergone in major abdominal surgery; to reduce post-operative morbidity & enhance better surgical outcome in children.Methodology: This is a randomized control trial carried out from January 2015-June2015,in a tertiary care hospital among 60 cases of 4 to 14 years children with major abdominal surgery without having any pulmonary, cardiac, hepatic or renal insufficiency. Grouping of patients that is lidocaine infusion group (Group A) and control group (Group B) was made among admitted cases for elective abdominal surgery by simple random technique by means of lottery. For assessment of postoperative pain FLACC Scale was used in both groups. Clinical examination findings & specifically designed data collection sheet with a set questionnaire were used as research instruments. Formulated data was analyzed by SPSS version 17, taking p value <0.05 as significant.Results: It is noted that, after 24 hours of operation most of the patients 56.7% of group A had mild pain whereas 90% patients of group B had moderate pain (p<0.001)& during that time there was no patient with severe pain in group A whereas in group B 10% patients were with severe pain. At 48 hours, pain was absent in 13.3% children of group A and 6.7% in group B. In group A most of the children 76.7%had mild pain compared to moderate pain 18 (60%) in group B children at that hours (P<0.001). Again, regarding required amount of analgesics, patients received I/V lidocaine required less amount of analgesics than its counterpart. In present study, complications was noted only 3.3% patien in group A, where as in the opposite group it was found in 23.3% & p was <0.05. In group A, in 50% patients post operative bowel sound was returned within 72 hours, compared to 73.3% patients in group B. The p value was 0.001. About post-operative hospital stay, 83.3% children of the group A were released from hospital after 5th P.O.D whereas, in group B, only 50% children were released after 7th P.O.D of operation. The P value was 0.03 that is also significant.Conclusion: Intravenous lidocaine could improve immediate and late post-operative pain with early recovery after major abdominal surgery in children & it can contribute to rapid postoperative rehabilitation programs.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 23-27
Abstract:Urethro cutaneous fistula( U-C fistula) is the most common complication of hypospadias surgery. It frequently needs separate surgeries for closure, which bring a great deal of physical and mental agony and monetary involvement of the patient and his family. Present study is probably a better technique to prevent fistulaassociated morbidities in distal Snodgrass TIP urethroplasties.
J Dhaka Medical College, Vol. 21, No. 2, October, 2012, Page 184-187 DOI: http://dx.doi.org/10.3329/jdmc.v21i2.15356
Infantile hemangiomas are the most common vascular tumor of infancy and childhood. Sometimes these lesions interfere with normal function & produce serious disfigurement that is unlikely to resolve on its own and then treatment is required. While evidence most supports the use of corticosteroids, there is no well- studied or Federal Drug Administration (FDA) approved systemic therapy for haemangiomas of Infancy. Dramatic improvement of complicated haemangioma by propranolol has recently been reported, but to date, details for initiating therapy, monitoring and potential risks in relation to Corticosteroids were not compared in a large scale. This research was designed to observe the effectiveness of oral propranolol compared to oral corticosteroid aimed at treatment of clinically important groups of infantile hemangiomas that require aggressive treatment. We conducted a randomized control study among the diagnosed case of infantile hemangiomas, age of <10 years. The total sample size was 60 (30 for propranolol group i.e. in group A, and 30 for corticosteroid group i.e. in group B) & grouping was done with the simple random technique. A clinical & photograph based VAS (Visual Analogue Scale) scale with a defined monitoring schedule was used for evaluation of treatment response. Our study result showed, (3.33%) patients of group A, response to color change (red-purple-grey) within 1st month of treatment whereas none of the patient (0.00%) of group B had any response to color by this time. Patients response to propranolol therapy was also continued even up to 5th month (3.33%) but it was absent (0.00%) in corticosteroid therapy even after 4th month & p= 0.025, that was statistically significant. Regarding the mean size (diameter) of the tumor, most of the tumor size reduced and near to stabilize at 4th month in group A, but in group B, the rate was slower and needed longer time (5-6 month), the p value was 0.030. Again 60% of tumor became non-palpable at 3rd week of treatment in group A patients, but in group B, 70% of tumor was still remain palpable on that time & p=0.001, that was statistically significant. Again, in Propranolol therapy group, the rate of complications was (24%) whereas in Corticosteroid therapy group, it was (76%).The p value was 0.020 that was also statistically significant. Hence, the present study results denote that, oral propranolol can be considered as an emerging and effective treatment over oral corticosteroid therapy for infantile hemangiomas.
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