Introduction: Carotid artery stenosis is one of the important causes of ischemic stroke. This may be diagnosed by Doppler Ultrasound and Digital Subtraction Angiogram (DSA) both of which have some advantages and disadvantages. Objective: The aim of this study was to assess extra-cranial carotid artery with the help of DSA among patients of ischemic stroke and transient ischemic attack (TIA). Materials and Methods: This observational cross sectional study was conducted in the Department of Neurology in Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka from July 2013 to June 2015 for a period of two years. This study included a total of 50 patients. Diagnostic performance test of DSA was done at 50%, 50-69%, 70-99%, 100% cut off point of stenosis of right internal carotid artery (RICA) and Left internal carotid artery (LICA). Results: The mean age of cases was 61 ± 11.42 years. Out of 50 vessels, maximum cases were diagnosed as <50% stenosis of carotid artery (26 cases of RICA, 23 cases of LICA. Out of 50 vessels, 50%-69%, 70 but _ less than near occlusion and total occlusion were found among 10, 10, 4 vessels in RICA and 10, 9, 8 vessels in LICA respectively. The present study showed that 50 vessels of RICA was measured by DSA and diagnosed 28 (56%), 10 (20%), 7 (14%) and 5 (10%) carotid vessels as _ 50%, 50-69%, _70% but less than total occluded and total occluded cases respectively. This study also showed that 50 vessels of LICA was measured by DSA and diagnosed 23 (56%), 12 (24%), 8 (16%), 7 (14%) carotid vessels as _ 50%, 50-69%, _ 70% but less than total occluded and total occluded cases respectively. Conclusion: DSA as the gold standard has amply been performed in most diagnostic circumstances of carotid artery stenosis. So, the present study was done to evaluate extra cranial carotid arterial system by DSA in stroke patients in Bangladesh. Medicine Today 2022 Vol.34(2): 121-124
Introduction: Proximal tibial injuries are challenging to treat because of articular surface involvement, frequent congestion, and precariat soft tissue conditions, particularly after high-energy traumas. The treatment is intended to restore the unity of the joint surfaces that supports the typically depressed tibial plateau cartilage, use a strong device to stabilize the fracture and prevent further damage, to enable early recovery. We describe our treatment approach, using closed or open decrease and internal fixation, polyaxy plates, automatic bone-gloss, or other osteoconductive material enhanced by autologous platelet gel, where required. Surgery depends on the timing of the soft tissue and is typically done directly or under the guidance of a skilled surgeon using tissue-sparing techniques as much as feasible. Materials and Methods: A prospective analysis of all (n=58) proximal tibial fractures at the Islamic Bank Medical College Hospital and multicentral tertiary level hospital, Rajshahi, Bangladesh, from January 2019 to June 2021. Patient data were collected by evaluating hospital diagrams, office records, preoperative and after operative radiograph. Fractures were classified in the classification of OTA/AO. In 78 % of the 12-month post-surgery group, the Rasmussen score's evaluation of functional outcomes found positive to outstanding results. Results: Total Number of patient n=58 tibial proximal (intra-articular) fractures have been identified. The mean age was 43 years (range 19–79) at surgery, whereas women and 39 men were 19. The most frequent injury mechanism was linked to traffic accidents (RTA), representing 75% of cases. 09 (18.4%) AO/OTA types A, 31 (53.5%) AO/OTA type B and 18, (31.1%) AO/OTA type C fractures have been identified. Most (90 %) cases (44) were treated with open reduction and internal fixation, using polyaxially anatomical angular stability locking Plates. Conclusions: Internal fixing using locking plates, following the MIPO principles (Minimally Invasive Percutaneous Osteosynthesis), offers an acceptable reduction of fractures with excellent outcomes for the medium-term clinical results. Medicine Today 2022 Vol.34(2): 93-98
Background: Most people experience headache at some point in their lifetime. Among them a small proportion suffers from migraine. It is difficult to estimate actual prevalence of headache. Objectives: The aim of our study was to measure frequency of migraine among school going children in Rajshahi city and to evaluate different presentations of migraine. Materials and Methods: This is a population based cross-sectional type of descriptive study in which the survey was conducted among school going children aged 12 -16 years at Rajshahi City from January, 2014 to December, 2015. The diagnostic criteria for migraine defined by International Headache Society (IHS) were used. After taking informed consent purposively collected total 271 migraine patients were enrolled for the proposed study. Screening questionnaire (Questionnaire A) was given to total 2000 students (girls 1000 and boys 1000). A detailed Questionnaire B was distributed to those who had headache. Result: Mean (+SD) age of student of migraine was 13(+1) years, highest proportion (43.54%) of student was between 13 to 15 years of age. Higher frequency of migraine was observed in girls (51.4%) as compared to boys (27.8%). Pulsatile headache is the commonest type of headache. Majority of students reported unilateral headache. 80.4% students reported their headache to aggravated by movement. Associated features were photophobia or phonophobia 63.5%, both 26.6%, nausea 82.7%, vomiting 30.6%. Most students (29.5%) reported sleep disturbance as the aggravating factor of migraine and they reported that their attack is relieved by rest. Conclusion: Early diagnosis and treatment of migraine as well as the education of health workers and families are very important. In our environment the numerical importance of this disease suggests the need to perform further and broader epidemiological studies. KYAMC Journal. 2022;12(04): 237-242
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