Introduction: Although modern anaesthesiology has made great progress in the last decades and spinal anaesthesia is popular for its effectiveness, Post Dural Puncture Headache (PDPH) is a significant and well known complication of spinal anaesthesia that may be incapacitating for patients. A few decades ago less refined and thicker spinal needles were being used and the incidence of PDPH was high. But within the last 15 years more refined and thinner needles have been used and the incidence of PDPH is grossly reduced.
Objective: To compare the incidence and severity of post dural puncture headache using 25 G Quincke and 27 G Quincke needle during spinal anaesthesia in case of caesarean section.
Materials and Methods: This randomized prospective study was carried out in the Border Guard Hospital, Dhaka, during the period of January to July, 2015. Patients were selected randomly from the age group of 20-35 years having a pregnancy of at least 34 weeks gestation with a single uncompromised fetus and uncomplicated pregnancy. Patients with a history of migraine, convulsion, cerebrovascular accident, Pre-eclampsia, eclampsia, spinal deformity, coagulopathy or previous neurological disease were excluded. They were randomly allocated into two groups. Each group consisting of 50 patients. Data was collected by interviewing and observation results. Data were processed and analyzed by using statistical test.
Results: There was no statistically significant difference found in age, height, weight and ASA status between two groups. 27G Quincke needle had significantly higher failure rate of successful lumber puncture in first attempt than the 25G Quincke needle (20% vs 6%, P<0.05). There was no difference difference regarding the incidence of intraoperative complications between two groups. The overall incidence of PDPH was 2(4%) in group A and 12 (24%) in group B (P<0.05). Decreased severity of headache was noted in the 27G group Quincke needle. There was no difference regarding the duration of headache in between two groups.
Conclusion: This study suggests that the risk of PDPH was much lower in 27G Quincke needle as compared to 25G Quincke needle though it had a higher failure rate of successful lumber puncture in first attempt. For spinal anaesthesia 27G Quincke needle should be used.
Journal of Armed Forces Medical College Bangladesh Vol.12(1) 2016: 17-21
HPV is a small, nonenveloped, double-stranded DNA virus, with a genome of approximately 8,000 nucleotides. Over 100 HPV genotypes have been isolated to date. Among these more than 40 have been shown to infect the genital tract, and 12 of them (genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58 and 59)
Pregnancy associated with obesity is a challenge1.When surgical delivery is indicated that present a unique challenge2. A case of pregnancy with morbid obesity with a successful outcome is presented here.
Bangladesh J Obstet Gynaecol, 2017; Vol. 32(1): 45-47
Cervical cancer is the second most frequent type of cancer and leading cause of mortality among women worldwide. More than eighty eight percent deaths from cervical cancer occur in developing countries and by 2030, it will be at least ninety eight percent. In developed countries, the cases and deaths have declined markedly due to their extensive screening programs. The present study was undertaken to assess precancerous and cancerous cervical lesion by cytology and their comparison with histopathology in VIA positive cases. This descriptive, cross-sectional type of observational study was carried out in the Department of Pathology, Mymensingh Medical College in collaboration with the Department of Gynecology and Obstetrics, Mymensingh Medical College Hospital, during the period of July 2012 to June 2013. Study was carried out among 160 VIA positive patients and selected by non-random judgment sampling from the colposcopy clinic. Histological findings revealed that the most common age group affected by different types of cervical lesions is 30 – 39 years. It also revealed that squamous cell carcinoma (SCC) was very much common in age group 40-49 years. The statistical value of accuracy, sensitivity and specificity of Pap smear cytology test and histopathology yielded some important directives. The sensitivity values of Pap smear cytology was found 87.50%. The accuracy of the Pap smears in this study was 88.13%. The present study show significant relationship between cytological test with histopathological diagnosis. However cytology testing is not suitable as a single test. In conclusion, it can be stated that combination of cytology (Pap smear) and histopathology would ultimately be more useful.
CBMJ 2015 July: Vol. 04 No. 02 P: 35-40
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