Prophylactic drainage of wounds is aimed to reduce the wound complications and thereby morbidity. Obese patients are at more risk. Wound management is a basic practice in surgery, especially after an elective abdominal surgery. Our task after surgery is to avoid and thereby to reduce the adverse effects of wound complications. Objective: To determine whether subcutaneous drainage can reduce such complications in patients undergoing elective and emergency abdominal surgery. Materials and Methods: It is a prospective open comparative study carried out Department of obstetrics and gynecology, in two hospitals Al-Hera Hospital, Mawna, Chowrasta, Sreepur, Gazipur and Shaheed Tajuddin Ahmad Medical College Hospital, Gazipur, Bangladesh over a period of six (6) months August 2021 to January 2022. Patients were randomized before surgery and divided into two groups by systemic random sampling. Total sample size 150 with 75 in each group. All patients will receive same preparations. Results: Wound complications observed in 2 patients with subcutaneous drain which forms 8% of the total patients with subcutaneous drain. Wound complications observed in 25 patients without subcutaneous drain which forms 33.3% of the total patients without subcutaneous drain. Comparing these two data found to be statistically significant with P value < 0.05. Thus the incidence of wound complication is low in those with subcutaneous drain than those without drain. Conclusion: Subcutaneous drain when kept in obese individuals with more subcutaneous fat thickness who undergo elective abdominal surgeries had lesser incidence of local wound complications and lesser hospital stay when compared to those patients without subcutaneous drain.
Introduction: Vitamin D (VitD) insufficiency is present in over half of population worldwide. Over a billion people worldwide are vitamin D deficient or insufficient. It has been long known that VitD insufficiency contributes to development of osteopenia and osteoporosis. Objective: To assess the serum vitamin D and TSH status in postmenopausal women who have undergone routine blood investigations. Methods: We performed a retrospective review of data of 61 patients in postmenopausal age group (45-75yrs) during their routine blood investigation for the first time at Dept. of Obstetrics and Gynaecology, Shaheed Tajuddin Ahmad Medical College Hospital, Gazipur, Bangladesh from January to March 2021. The data was collected from medical record section and appropriate statistical analysis was done using percentage and frequency. Results: Out of 61 patients Vitamin D was insufficient (10-30 ng/mL) in 34.4% and deficient (<10 ng/mL) in 18.0%, and remaining normal. In 4.9%, TSH was low (less than 0.3 mIU/L) and in 18.0% TSH was high (more than 4.5 mIU/L), while the remaining 77.0 had normal TSH levels (0.3-4.5 mIU/L). 54.5%(n-11) patients with high TSH, had vitamin D deficiency and 18% patients with high TSH had insufficient vitamin D. 100% (n-3) of patients with low TSH had normal vitamin D. 22 patients had normal TSH and normal vitamin D. Conclusion: Prospective longitudinal studies with larger subject numbers and more comprehensive measurement of thyroid function along with examining the indicators of innate immunity may shed light into the underlying pathophysiology and mechanisms involved in the interaction between thyroid function and VitD metabolism. High TSH levels was associated with low vitamin D levels, low TSH levels was associated with normal serum vitamin D level. Hence association was linear between TSH and vitamin D in post-menopausal women.
Introduction: PEFR is considered as the simplest index of pulmonary function. Ventilatory function tests like PEFR provide a better understanding of the changes in the lungs from a diagnostic viewpoint. It is effort dependent and reflects mainly the calibre of the bronchi and larger bronchioles, which are subjected to reflex bronchoconstriction. Objective: To study the variations in the PEFR with various factors with respect to age, body mass index, blood pressure and heart rate among males and females patients. Methods: This was a cross-sectional study conducted at Department of Medicine, Shaheed Tajuddin Ahmad Medical College Hospital, Gazipur, Bangladesh from January to December 2020 among young male and female subjects. The subjects with no history of cardio, availability & capacity to cooperate adequately, non- smokers; and no history of any drug intake which could affect the lung functioning were included in the study. PEFR was measured with the subject comfortably seated during the same time of the day for all subjects. It was determined in litres/minute with the help of “The Peak”, Individualised Peak flow meter from Multispiro Inc. Results: Out of the total subjects 121 subjects, 45.4% were ≤18 years followed by 19-20 (42.1%) and >20 (12.3%). There were 37.1% males and 62.8% females. PEFR was found to be significantly (p=0.0001) higher among males compared to females in all the age groups. PEFR increased with increasing age in both male and female subjects. PEFR was found to be significantly (p<0.0) higher among males compared to females in the entire body mass index (BMI) category. PEFR increased with increasing BMI in both male and female subjects. Conclusion: PEFR is higher among male than female subject. Also, PEFR was higher in males than females in all the age groups and BMI status. The effects of various factors like age, height, weight, BSA and BMI on the PEFR values have also been discussed in this study. PEFR increases with increase in age and BMI in both male and female subjects.
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