Cytologist-led fine needle aspiration cytology would have reduced the time to diagnosis and the number of clinic visits per patient. Fine needle aspiration cytology was accurate for predicting malignancy in salivary gland and lymph node lesions, and for diagnosing lymph node pathology. Study results did not support the use of ultrasound guidance during fine needle aspiration cytology.
The present study aimed at exploring the causes of re laparotomy following Caesarean section and to find out the pathway how to avoid these complications. This is a hospital based prospective study conducted in the Department of Obstetrics and Gynaecology, Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh from August 2007 to August 2008. Bangladeshi pregnant women are at risk of serious complications during pregnancy and labor due to lack of antenatal, intra natal and postnatal care. DMCH is the largest referral hospital in Bangladesh and more than ten thousand patients admitted here each year with different pregnancy and child birth related complications. Among them, 54 puerpera needed re laparotomy after Caesarean section within 6 weeks of Caesarean Section. Of the 54 cases, 28 had primary PPH, 14 patients had secondary post-partum hemorrhage (PPH), 4 cases had puerperal sepsis and 3 women had wound dehiscence, and 5 cases had sub rectus hematoma. Irreversible hemorrhagic shock (12cases), cardio genic shock (1 case), not reversed from anesthesia (1 case), acute renal failure (3cases) and puerperal sepsis (1 case) were causes maternal death. It gave the overall case fatality rate was 33.33%. Obstetric patients who return to the operation theater face potential death. This study will help us to identify the risk situations where re laparotomy may be needed and due precautions and prevention may be taken as far as possible to avoid this complications following caesarean section and thereby reduce maternal mortality and morbidity. Key word: Cesarean section; laparotomy; maternal morbidity; maternal mortality; case fatality. DOI: http://dx.doi.org/10.3329/jdmc.v20i1.8583 J Dhaka Med Coll. 2011; 20(1) :57-62
Inguinal hernia is one of the commonest conditions in paediatric surgical practice that requires surgical repair. Open repair is a conventional procedure. With the advance of minimally invasive surgery, laparoscopic repair of childhood inguinal hernia has been attempted. Now many centres practice it routinely. From different studies, reported advantages are excellent visual exposure, minimal dissection, and thus fewer trauma to the inguinal canal and its content, detection, and repair of contralateral hernia (if present) in same setting, less post-operative pain, early recovery, and better cosmesis. To date, despite increased interest in laparoscopic repair, there is no published study focusing on paediatric inguinal hernia in Bangladesh. So the present study is designed to assess the above mentioned clinical benefits of this method and to compare the laparoscopic repair and open repair of paediatric inguinal hernia. Materials and Methods: This prospective comparative interventional study was carried out in the Department of Paediatric Surgery, DMCH, Dhaka, during the period of May 2009 to June 2012. Total 60 patients were included in this study. Among them 30 patients in Group-L were repaired by laparoscopic procedure and another 30 patients in Group-O were repaired by open procedure. Both groups were followed-up for 3 months. The early post-operative complications were almost same and there was no recurrence in any groups. Results: It was found that laparoscopic repair is superior to open repair with regards to early pain relief and cosmesis. Moreover, on laparoscopy, detection of contralateral hernia or contralateral patent processus vaginalis and repair is possible in the same setting. Conclusions: Laparoscopic repair is superior with regard to early pain relief and cosmesis, but needs to be evaluated on wider group of patients and long period of follow-up.
Thrombocytopenia in pregnancy has many common causes, including gestational thrombocytopenia, viral and bacterial infections, and preeclampsia complicated by hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome. The great concern for ITP during pregnancy is the risk of thrombocytopenia in the newborn infant. A 30yrs old 3rd gravid women was admitted in maternity unit 3, Dhaka Medical College Hospital with the complaints of 36weeks pregnancy, lower abdominal pain and less fetal movement. She had been suffering from severe thrombocytopenia for the last 8 months. She treated with Prednisolone during pregnancy period, platelet transfusion before and after delivery and Danazol in puerperium. Her baby was delivered by caesarean section .Her intra-operative and post operative period was uneventful. She delivered a healthy male baby weighted 2.5 kg and breast feeding established successfully. She was discharged on seventh post operative day. The aim of this case report to reveal pregnancy with ITP and its clinical presentation, investigation and management with review of relevant literatures. DOI: 10.3329/jbcps.v28i3.6516J Bangladesh Coll Phys Surg 2010; 28: 196-198
Background: Termination of pregnancy is well prescribed method all over the world to terminate the early pregnancy with the combination of mifepristone and misoprostol tablet orally.Objective: The purpose of this present study was to determine the efficacy of mifipristone (200 mg) for medical termination of early pregnancy with oral misoprostol 800 mcg 24 hours later.Methodology: This observational study was done in the Department of Gynaecology & Obstetrics at Shaheed Suhrawardy Medical College & Hospital, Dhaka, Bangladesh among outdoor patients in 6 months period from July 2014 to December 2014. The patients with intrauterine pregnancy up to 9 weeks and blighted ovum were included. Incomplete abortion and extrauterine pregnancy were excluded. Mifepristone 200 mg followed by misoprostol 800 mg after 24 hours had been given.Result: Total 50 patients with 9 weeks of pregnancy were selected over the period of 6 months requesting termination of pregnancy. This study showed termination of early pregnancy up to 9 weeks with tablet mifepristone and tablet misoprostole which was effective as well as the expulsion rate of the product of conception was 92.0% cases and among them 32.0% patients were needed extended dose of misoprostol and 8.0% cases had incomplete abortion who needed surgical evacuation. Some patients had some complications like vomiting, fever, abdominal pain and excessive per vaginal bleeding which were managed accordingly.Conclusion: Mifepristone 200 mg followed by misoprostol 800 mcg orally is an effective method for termination early pregnancy with minimum side effects.Journal of Science Foundation 2017;15(1):9-13
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