Background: Infantile Hemangioma (IH) is one of the most common childhood neoplasm. Current treatments for children with endangering Infantile Hemangioma are limited, and include primarily oral corticosteroid which has many systemic adverse effects. Furthermore, approximately one third of IH does not respond to oral steroids, prompting active investigations for new treatments.Objective: To compare the efficacy, side effects, and influencing factors of oral Prednisolone and intralesional Dexamethasone (IL) in treatment of IH and thus to find out an effective, cheap and safe modality of treatment for this anomaly.Materials and Methods: This study was carried out on 48 patients of IH with the age range from 1 day to 12 years. Group A (n1=26) patients were treated by oral Prednisolone and group B (n2=22) patients were treated by IL Dexamethasone .Periorbital Hemangioma and IH >54 cubic centimeter were excluded. Therapeutic response of Prednisolone and Dexamethasone was graded as excellent, good, poor and no response. We monitored volume of the lesion and its color change to evaluate the response to treatment.Results: Overall therapeutic responses were 69.2% in Group A and 68.2% in group B. Side effects were noted in 65.4% patient of group A and 36.4% patient of group B. In group A, the commonest (38.5%) side effect was excessive weight gain with cushingoid facies and in group B, commonest (27.3%) side effect was ulceration at injection site. Side effects were more in children of group A. Range of treatment was 4-20 weeks in group A and in group B, it was 4-24 weeks.Conclusion: IL Dexamethasone is effective as oral Prednisolone for treatment of IH .Unlike Prednisolone, IL Dexamethasone is devoid of systemic side effects.J. Paediatr. Surg. Bangladesh 5(1): 12-19, 2014 (January)
Background : Acute appendicitis is one of the commonest surgical emergencies in children and malnutrition is prevalent in the country. This study was designed to compare if complicated appendicitis occurs more in malnourished children. Materials and methods: This cross-sectional study was conducted in Department of Paediatric Surgery, Chittagong Medical College Hospital from March 2017 to December 2019 with 155 children. Anthropometric measurements (Height, weight, Mid Upper Arm Circumference (MUAC) Triceps Skin Fold Thickness (TSFT) were recorded and biochemical assessment (Haemoglobin, albumin and total lymphocyte count) were done before surgery. Patients were grouped into two groups: Group A (Acute uncomplicated appendicitis; n=65) and Group B (Acute complicated appendicitis, n=90). Anthropometric and biochemical indices were compared between these two groups. Results: Age ranged from 2 -12 years (Mean 9.2 ±2.5 years) (Male: female- 1.35:1). Among the five anthropometric indices abnormal measurements in Group A vs Group B were respectively. Abnormal TSFT (73.8% vs 80%, p=0.4) wasting (38.5% vs 44.4%, p=0.4) low MUAC for age (13.8% vs 17.8%, p=0.8) low weight for age (30.8% vs 36.7%, p=0.5) and low height for age (21.5% vs 24.4%, p=0.7) low albumin (52.3% vs 83.3%, p<0,001); low haemoglobin (61.5% vs 60.0%, p=0.6)) and low total lymphocyte count (39.5% vs 44.8%, p=0.7). Conclusions: Malnutrition was widely prevalent in both groups. Although the proportion of malnutrition was more with acute complicated appendicitis, it was not statistically significant. The lower serum albumin level in these patients might be due to the consequence of the disease rather than prevailing malnutrition. JCMCTA 2022 ; 33 (1) : 66-70
Background: Chronic anal fissure is one of the most frequent proctological disorders worldwide. Closed Lateral Internal Sphincterotomy (LIS) is one of the therapeutic options accepted as the treatment of choice for Chronic Anal Fissure (CAF) as it reduces the hypertonia of the internal anal sphincter, decreases anal pain, and allows the fissure to heal. LIS can be done under general anesthesia or local anesthesia. Aim of this study was to see the post operative outcome of closed LIS done under local anaesthesia. Materials and methods : This retrospective study was conducted in Department of Surgery of Chattogram Medical College hospital and some private hospitals of Chattogram city from January 2008 to December 2017. Total 550 patients of CAF who underwent closed LIS under local anesthesia were included. Atypical fissures associated with other disease were excluded. Results: The mean duration of hospital stay was 3.38 ± 1.2 hours. Sentinel skin tag was excised in 296 patients. The fissure was posterior in 73.63% patients and anterior in 7.81% patients. Recurrence was noted in 1.3% patients within four months. 63.27% patients experienced normal continence except occasional lack of fecal control postoperatively and only one patient developed gross incontinence of solid and liquid stool. Conclusion : This study concluded that closed LIS under local anaesthesia is the procedure of choice for management of CAF as it is cost effective and time saving. JCMCTA 2018 ; 29 (2) : 53-56
Background : Infantile hemangioma is a benign vascular tumor. Considerable controversy exists as to the management of hemangiomas. The purpose of this study was to see the efficacy and safety of orally administered prednisolone and propranolol in combination for treatment of potentially disfiguring or functionally threatening hemangiomas Materials and methods: In this prospective study, thirty two patients of hemangioma with age range of 1 month to 5 years were included who were treated with oral propranolol (1 mg/kg/ day in two divided doses) and oral prednisolone (2 mg/Kg/ day in single dose) in combination. This study was conducted in outpatient Department of Pediatric Surgery of Chattogram Medical College Hospital from January 2016 to December 2017. Changes in size and color of lesions were the two evaluating factors to see the efficacy of the treatment. Therapeutic response was graded as excellent, good, poor and no response. Results: Overall therapeutic response was 92.62% (29 patients). Excellent response was noted in 21 patients (65.62%) and in 3 patients (9.38%) there was no response. Range of treatment period was 6 to 20 weeks. No side effects except excessive weight gain was noted (6.25%). Conclusion: Combined use of low dose oral prednisolone and propranolol is more effective and safe for treatment of hemangioma. Chatt Maa Shi Hosp Med Coll J; Vol.18 (2); July 2019; Page 23-26
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