This prospective case-control study was conducted on 105 consecutive cases admitted to the burn units of Dhaka Shishu Hospital and Dhaka Medical College Hospital. The same number of controls were selected randomly from the community and matched with respect to age group, sex, and location of residence within the defined metropolitan area during the period January to September 1997. Both the controls and cases were divided into three age groups. Group A (19 controls and 19 cases) included neonates and infants, group B included children from 1 to 4 years, and group C included children from 4 to 12 years. The mean age of the controls in group A was 8.42+/-3.86 months and in group B and C was 5.72+/-4.05 years. The mean age of cases in group A was 4.79+/-4.05 months and in group B and C was 5.08+/-2.87 years. A scoring system was used to analyze 14 socioeconomic and cultural factors, which indicated highly significant differences between controls and cases (P < 0.001), and also between male (P < 0.001) and female (P < 0.001) controls and cases. There were significant differences between controls and cases in group A (P < 0.001), group B (P < 0.01), and group C (P < 0.001). Differences were not significant between males and females within groups A, B, and C for cases or controls (P > 0.05). Regression analysis of the total scores for cases and controls indicated a negative correlation between burns and the socioeconomic variables included in the study. There were highly significant associations between burns and lack of alertness to burns among parents (P < 0.001), clothing of manmade fabrics (P < 0.001), and cooking equipment in the kitchen within reach of children (P < 0.001). There was a significant association between burns and illiteracy of the mother (P < 0.01), housing located in slums and congested areas (P < 0.01), illiteracy of the father (P < 0.02), presence of preexisting impairment in children (P < 0.05), presence of a history of burns among siblings (P < 0.05), and low economic status of the parents (P < 0.05). No significant associations were indicated between controls and cases with respect to number of children in the family (P > 0.1), family pattern (P > 0.1), conjugal bonding between parents (P > 0.5), and sibling's death and disability from burns (P > 0.5). It is evident that an increase in alertness to burns, easy availability of clothing of natural fabrics, keeping cooking equipment beyond the reach of the children, increased literacy among parents and children, and improvement in family income might decrease the incidence of burns in children.
EEG is not so commonly used in patients attending psychiatry department. It is predominantly required to rule out any organic cause behind the behavioral changes. Purpose of this study was to assess the referred cases from psychiatry department and determine the clinical factors associated with an abnormal EEG in patients with psychiatric problem. We retrospectively reviewed and analyzed the data of all the cases referred to EEG lab. Introduction:Electroencephalography (EEG) is the recording of electrical activity along the scalp produced by the firing of neurons within the brain. In clinical contexts, EEG refers to the recording of the brain's spontaneous electrical activity over a short period of time, usually 20-40 minutes, as recorded from multiple electrodes placed on the scalp. In neurology, the main diagnostic application of EEG is in the case of epilepsy, as epileptic activity can create clear abnormalities on a standard EEG study. A secondary clinical use of EEG is in the diagnosis of coma, encephalopathy, and brain death. 1
Objective: To identify the common risk factors associated with carpal tunnel syndrome. Methodology:This case-control observational study was conducted in the department of neurology and medicine, DMCH from May 2010 to April 2011 for a duration of 1 year. The study included purposively selected 80 persons. Patients attending the outdoor and admitted in indoor of department of neurology and medicine, DMCH with a clinically suspected CTS and established by electrophysiological parameters selected as cases (group –I) . Healthy volunteers and subjects who were devoid of any features of CTS but having history with isolated injury to the lower limb nerve and isolated facial nerve palsy with normal electrophysiological parameters selected as control (group –II). Data were collected by interview of the patients, clinical examination and laboratory investigations using the research instrument. Result: The mean age was 42.7±9.8 years with range from 24 to 64 years and 41.1±9.1 years with range from 26 to 61 years in group-I and group-II respectively. The proportion of male and female patients was similar in both the study groups. Male Female ratio was 1: 7 in both groups. In this study it was observed that hypothyroidism was found 25.0% in group I and 5.0% in group II, which was significantly (p<0.05) higher in carpal tunnel syndrome patients. Diabetes mellitus was significantly higher in carpal tunnel syndrome patients, which was 22.5% in group I and 7.5% in group II. Rheumatoid arthritis was found 20.0% in group I and 5.0% in group II, which was significantly (p<0.05) higher in patients with carpal tunnel syndrome. Pregnancy was found 11.4% in group I and 2.9% in group II. CKD with hemodialysis was found 17.5% and 7.5% in group I and group II respectively. In pregnancy and CKD with hemodialysis difference was not statistically significant (p>0.05) among the two groups. Regarding obesity it was found in this present series that 42.5% and 17.5% patients were obese in group I and group II respectively. Obesity was significantly (p<0.05) higher in patients with carpal tunnel syndrome. In this study it was found in multivariate analysis that patients with hypothyroidism 1.28 times, DM 2.20 times, RA disease 3.84 times, obesity 5.9 times more likely to be associated with carpal tunnel syndrome but CKD with hemodialysis patients and pregnancy were not significantly associated in multivariate analysis. In this study it was also found that almost a half (47.5%) of the patients was housewives followed by garment workers (27.5%) and clerical workers (22.5%) in group I, which indicates that carpal tunnel syndrome was more common among housewives. Conclusion: A conclusion can be made from the above mentioned result that CTS is multifactorial. Obesity, diabetes mellitus, hypothyroidism and rheumatoid arthritis are commonly associated with carpal tunnel syndrome. Moreover female sex and age were also associated with CTS. This study also found that patients diagnosed as having work-related CTS have a high prevalence of concurrent medical conditions capable of causing CTS without respect to any particular occupation. Bangladesh Journal of Neuroscience 2013; Vol. 29 (2) : 70-78
Subarachnoid hemorrhage (SAH) due to rupture aneurysm is a neurologic catastrophe with a very high risk of rebleeding if the aneurysm is not treated. Endovascular coiling has becoming common and has replaced neurosurgical clipping as the treatment of choice. A 48-year-old man came to us with the history of SAH from ruptured cerebral arterial aneurysm and for the first time in the history of Dhaka Medical College Hospital, we had successfully treated by Endovascular coiling. Key words: Subarachnoid haemorrhage (SAH); cerebral DSA; surgical clipping; endovascular coiling. DOI: 10.3329/jdmc.v17i2.6597J Dhaka Med Coll. 2008; 17(2) : 131-133
This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page. We invite readers to contribute case presentations and discussions. Case 1 Presentation An 11-month-old boy is brought to the emergency department because of 3 days of fever, "crossed eyes," and a discharge of bloody pus from his left ear. His mother also has noticed that he is less steady on his feet. His left ear has been infected for 6 months despite therapy with amoxicillin/clavulanate, cefpodoxime, clarithromycin, ceftriaxone, cefaclor, and antibiotic drops with hydrocortisone. The mother states that she has been fully compliant with the drug regimens. On physical examination, the child's height and weight are in the 50th percentile. He tugs frequently at both ears but is afebrile and does not look ill. He is unable to move his left eye laterally past midline, giving him a cross-eyed appearance on left lateral gaze.
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