Introduction: Neurodisability is an umbrella term for conditions associated with impairment involving the nervous system. The parents of these children remain worried about the cause of the disability and seek the diagnosis. Nowadays radiological diagnosis by CT scan is possible in most of the cases which may help in the management of such children. Objective: To correlate between clinical and CT scan findings in neurodisabled children. Materials and Methods: One hundred children with neurodisability were selected randomly who were scanned by 6, 16 and 128 slice CT scanners. This retrospective study was conducted in CMH Dhaka and Central Hospital Limited, Dhaka in between 2010 to 2014. Results: Abnormal CT scan was found in 57 cases out of 100 patients having neurodisability. A large number of patients having neurodisability are suffering from psychomotor delay, motor delay, seizure disorder and speech difficulty. Hypoxic ischaemic injury in perinatal period is one of the major causes of the disability. Conclusion: CT scan is very effective to find out the cause of neurodisability in less time (around 25 to 30 seconds) and is widely available in Bangladesh. Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 93-97
Introduction: Now a days Magnetic Resonance Imaging (MRI) has become the primary investigation for the assessment of knee injuries. Non-invasive MRI has the ability of high resolution and accuracy to diagnose the knee injuries and it can be the alternative to diagnostic arthroscopy. Objective: To validate MRI evaluation in the assessment of cruciate ligamentous and meniscal injuries of the knee joint and compare with arthroscopic findings. Materials and Methods: This cross sectional study was conducted at Combined Military Hospital, Dhaka from 01 January 2013 to 30 June 2013 where sixty patients who had the history of twisting injuries to the knee were selected in this study. Along with injury history they were strongly suspected to have meniscal and/or cruciate ligamentous tears. Then they were examined by open MRI machine 0.4 tesla, Hitachi, made in Japan. A Quadrature (QD) extremity coil was used in this study. Spin echo T1, fast spin echo T2 and Short Tau Inversion Recovery (STIR) sequences were taken in direct coronal, sagittal and axial planes with 4mm slice thickness. Data were recorded and statistical analysis was done by SPSS version 20. Results: Total 60 patients underwent MRI and Arthroscopic examination. The final diagnosis was established by direct findings at Arthroscopic examination. The Sensitivity, Specificity and Accuracy of Magnetic Resonance Imaging in the diagnosis of cruciate ligamentous and meniscal injuries as compared to arthroscopy were Anterior Cruciate Ligament (ACL): 96.88% sensitivity, 96.43% specificity, 96.66% accuracy, 96.87% Positive predictive value (PPV) and 96.42% Negative predictive value (NPV); Medial Meniscus (MM): 96.43% sensitivity, 98.87% specificity,96.66% accuracy, 96.42% PPV and 98.88% NPV; for Lateral Meniscus (LM): 80.00% sensitivity, 97.77% specificity, 93.33% accuracy, 92.30% PPV and 93.62% NPV. Conclusion: As a non-invasive diagnostic modality Magnetic Resonance Imaging is very useful and having high sensitivity, specificity and accuracy in the detection of meniscal and cruciate ligament injuries. To prevent unwanted arthroscopies MRI should be done in every patient of suspected cruciate ligamentous and meniscal injury before doing arthroscopy. Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 95-98
Introduction: Breast cancer is the most common cancer and second leading cause of cancer deaths in women. Early detection, efficient and accurate diagnosis can reduce the mortality rate. Objectives: To compare the screening accuracy of mammography (MMG) and ultrasonography (USG) in suspected cases of breast masses. Material and Methods: This cross-sectional analytical study was carried out in the Department of Radiology and Imaging, Combined Military Hospital, Dhaka from June 2016 to July 2017. A total of 100 clinically suspected case of breast masses aged from 20 to 75 years referred for MMG and USG was selected. Each patient underwent USG and MMG followed by a histopathological examination of the biopsy material taken from the lump lesion. Two cases histopathological report was not found. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of USG and MMG were compared with histopathology as the gold standard. In order to determine the agreement of diagnoses between USG and MMG, consistency analysis was performed using Kappa-statistics. Results: Sensitivity, specificity, PPV, NPV and diagnostic accuracy of USG was 58.8%, 98.4%, 77.8%, 85.0% and 83.6% and for MMG 92.0%, 84.5%, 67.6%, 96.8% and 84.7% respectively. Kappa-statistics shows that the two diagnostic modalities had a test agreement in 39.8% cases to differentiate malignant breast tumour from the benign one (k-value = 0.398, p > 0.05). Conclusion: Two diagnostic modalities USG and MMG had a fair agreement in the differentiation of malignant breast tumour from the benign. Journal of Armed Forces Medical College Bangladesh Vol.13(2) 2017: 22-24
Introduction: Digital Substraction Angiography (DSA) is the gold standard for proper diagnosis and further evaluation of intra cranial aneurysm. Intracranial aneurysm rupture leading to Subarachnoid hemorrhage (SAH) may be associated with serious neurological sequelae or even mortality. According to international literature, only aneurysm >7 mm or aneurysm in the posterior circulation require treatment. Retrospective single center studies have however, disputed that the average size of ruptured aneurysms are <7 mm. Objective: To assess the aneurysm characteristics and demographics of patients who reported to CMH, Dhaka with SAH secondary to an aneurysm detected at Digital Subtraction Angiography (DSA). Materials and Methods: This retrospective study was conducted among the patients who presented with SAH more than 3 year period, from November 2013 to April 2017. All patients had undergone CT scan of brain in the department of Radiology & Imaging and DSA in the Cath Lab of Combined Military Hospital (CMH), Dhaka. Data about aneurysm characteristics, size and patient demographics were obtained from patients files. Results: A total of 74 patients underwent DSA and amongst them 32 patients had ruptured aneurysms. Ages ranging from 20 to 75 years (mean 45 years), little more male patients. The mean size of aneurysms was 5.8mm (range 1.2 mm to 20 mm) with 74.5% of aneurysms having size <7 mm. Most aneurysms were noted involving anterior circulation (72%) with the majority arising from the anterior communicating (ACom) artery (36.7%). Conclusion: An aneurysm is an abnormal dilatation of an artery. It can be found in almost any age and can rupture at size <7 mm. Those are commonly located in the anterior circulation. Findings of this study emphasize the importance of conducting the institutional reviews, to consider adapting the international treatment guidelines. Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 107-110
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