Pub Date : 2022-09-05DOI: 10.3329/kyamcj.v13i2.61333
Miraj Hossain, Major Muhammad Nazrul Islam, Zannatul Ferdous Happy, Moinul Hossain, A. Akhtaruzzaman
Background: Transversus Abdominis Plane (TAP) block is a regional anaesthetic technique used for postoperative pain management following abdominal surgery. Local anesthetics like bupivacaine can be used in this block and it can be performed in various approaches. Among them ultrasound-guided lateral and posterior approaches are popular. Objective: Aim of this study is to compare the effectiveness of lateral and posterior approaches of ultrasound-guided TAP block using bupivacaine in the management of post-operative pain after total abdominal hysterectomy under subarachnoid anesthesia. Materials and Methods: This randomized clinical trial was carried out in the Department of Anaesthesia, Analgesia and Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka. Total 90 patients were scheduled for elective total abdominal hysterectomy and assigned into two equal groups, group A and group B received ultrasound guided TAP block in lateral approach and in posterior approach respectively. Then patients were observed for pain intensity at rest and during deep breath by visual analog scale (VAS), after 1 hour, 2 hours, 4 hours, 6 hours, 12 hours and 24 hours of TAP block. The time of first analgesic demand was noted. Statistical analyses of the results were obtained by using window based computer software devised with Statistical Packages for Social Sciences (SPSS-22). Results: The mean pain intensity at rest and during deep breath was statistically significant (p<0.05) at 4, 6, 12 and 24 hours after TAP between two groups. The mean duration of first analgesic demand was 5.04±0.54 hours in group A and 6.59±0.69 hours in group B was statistically significant (p<0.05) between two groups. Conclusion: TAP block in posterior approach provided considerably effective postoperative analgesia in first 24 hours than lateral approach after total abdominal hysterectomy. KYAMC Journal Vol. 13, No. 02, July 2022: 66-71
背景:腹横面阻滞(TAP)是一种用于腹部手术后疼痛管理的区域麻醉技术。像布比卡因这样的局部麻醉剂可以在这个街区使用，并且可以通过各种方式进行。其中超声引导下的外侧入路和后路是常用的入路。目的:比较超声引导下布比卡因侧路和后路TAP阻滞治疗蛛网膜下腔麻醉下全腹子宫切除术后疼痛的效果。材料与方法:本随机临床试验在达卡班班杜谢赫穆吉布医科大学(BSMMU)麻醉、镇痛和重症监护医学系进行。选择择期腹式全子宫切除术90例患者，随机分为两组，A组和B组分别行超声引导下外侧入路和后入路TAP阻滞。通过视觉模拟评分法(VAS)观察患者在TAP阻滞1小时、2小时、4小时、6小时、12小时和24小时后休息时和深呼吸时的疼痛强度。记录首次使用镇痛药的时间。采用SPSS-22 (Statistical Packages for Social Sciences)软件进行统计分析。结果:两组在TAP后4、6、12、24 h静息和深呼吸时的平均疼痛强度比较，差异均有统计学意义(p<0.05)。A组和B组患者首次镇痛需求平均持续时间分别为5.04±0.54 h和6.59±0.69 h，两组间差异有统计学意义(p<0.05)。结论:TAP阻滞在全腹子宫切除术后24小时内的镇痛效果明显优于外侧入路。KYAMC杂志第13卷，第02期，2022年7月:66-71
{"title":"Comparison Between The Effectiveness of Lateral and Posterior Transversus Abdominis Plane Block by Using Bupivacaine After Total Abdominal Hysterectomy.","authors":"Miraj Hossain, Major Muhammad Nazrul Islam, Zannatul Ferdous Happy, Moinul Hossain, A. Akhtaruzzaman","doi":"10.3329/kyamcj.v13i2.61333","DOIUrl":"https://doi.org/10.3329/kyamcj.v13i2.61333","url":null,"abstract":"Background: Transversus Abdominis Plane (TAP) block is a regional anaesthetic technique used for postoperative pain management following abdominal surgery. Local anesthetics like bupivacaine can be used in this block and it can be performed in various approaches. Among them ultrasound-guided lateral and posterior approaches are popular.\u0000Objective: Aim of this study is to compare the effectiveness of lateral and posterior approaches of ultrasound-guided TAP block using bupivacaine in the management of post-operative pain after total abdominal hysterectomy under subarachnoid anesthesia.\u0000Materials and Methods: This randomized clinical trial was carried out in the Department of Anaesthesia, Analgesia and Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka. Total 90 patients were scheduled for elective total abdominal hysterectomy and assigned into two equal groups, group A and group B received ultrasound guided TAP block in lateral approach and in posterior approach respectively. Then patients were observed for pain intensity at rest and during deep breath by visual analog scale (VAS), after 1 hour, 2 hours, 4 hours, 6 hours, 12 hours and 24 hours of TAP block. The time of first analgesic demand was noted. Statistical analyses of the results were obtained by using window based computer software devised with Statistical Packages for Social Sciences (SPSS-22).\u0000Results: The mean pain intensity at rest and during deep breath was statistically significant (p<0.05) at 4, 6, 12 and 24 hours after TAP between two groups. The mean duration of first analgesic demand was 5.04±0.54 hours in group A and 6.59±0.69 hours in group B was statistically significant (p<0.05) between two groups.\u0000Conclusion: TAP block in posterior approach provided considerably effective postoperative analgesia in first 24 hours than lateral approach after total abdominal hysterectomy.\u0000KYAMC Journal Vol. 13, No. 02, July 2022: 66-71","PeriodicalId":17948,"journal":{"name":"KYAMC Journal","volume":"15 12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86658344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-05DOI: 10.3329/kyamcj.v13i2.61343
U. Ghosh, Md Imrul Kaes, Md Abdul Hadi Al Mamun, M. Razzaque
A 7-year-old girl, 2nd issue of non-consanguineous parents hailing from Rajshahi got attended to our outpatient department of Pediatrics with the complaints of white patches all over the body since early infancy, poor intelligence, and speech problems. There was history of developmental delay but no history of seizures or visual problems or hearing impairment. She also had dental abnormalities. Family history was not significant. For these she treated with several oral and local antibacterial, antifungal and corticostresoid medications, but no improvement. Examination revealed symmetrical hypopigmented patches involving the trunk and upper limbs, and were following Blaschko’s lines. Anthropometry and others examination were normal. The hearing assessment was normal. There were no ocular abnormalities but have delayed dentation with mal-alignment of teeth with carries. She have moderate level of intellectual disability (ID). Our diagnosis was hypomelanosis of Ito (HI); a rare type of neurocuteneous syndrome. Routine investigations were normal, CT scan of the brain showed mild cortical atrophy, EEG was normal. The parents were counseled about the recent level of intellectual functioning, asked to allow the child for learning self-help skills, and referred to a child development center, child psychologist, and speech therapist. Our patients were well and no complications were observed till writing this report. We like to share our experience of diagnosing and treating this very rare disease of HI. KYAMC Journal Vol. 13, No. 02, July 2022: 120-123
{"title":"Hypomelanosis of Ito: Neurocuteneous Syndrome","authors":"U. Ghosh, Md Imrul Kaes, Md Abdul Hadi Al Mamun, M. Razzaque","doi":"10.3329/kyamcj.v13i2.61343","DOIUrl":"https://doi.org/10.3329/kyamcj.v13i2.61343","url":null,"abstract":"A 7-year-old girl, 2nd issue of non-consanguineous parents hailing from Rajshahi got attended to our outpatient department of Pediatrics with the complaints of white patches all over the body since early infancy, poor intelligence, and speech problems. There was history of developmental delay but no history of seizures or visual problems or hearing impairment. She also had dental abnormalities. Family history was not significant. For these she treated with several oral and local antibacterial, antifungal and corticostresoid medications, but no improvement. Examination revealed symmetrical hypopigmented patches involving the trunk and upper limbs, and were following Blaschko’s lines. Anthropometry and others examination were normal. The hearing assessment was normal. There were no ocular abnormalities but have delayed dentation with mal-alignment of teeth with carries. She have moderate level of intellectual disability (ID). Our diagnosis was hypomelanosis of Ito (HI); a rare type of neurocuteneous syndrome. Routine investigations were normal, CT scan of the brain showed mild cortical atrophy, EEG was normal. The parents were counseled about the recent level of intellectual functioning, asked to allow the child for learning self-help skills, and referred to a child development center, child psychologist, and speech therapist. Our patients were well and no complications were observed till writing this report. We like to share our experience of diagnosing and treating this very rare disease of HI.\u0000KYAMC Journal Vol. 13, No. 02, July 2022: 120-123","PeriodicalId":17948,"journal":{"name":"KYAMC Journal","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76927697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-05DOI: 10.3329/kyamcj.v13i2.61342
Akm Shahidur Rahman, Nishat Parvin, Md. Moniruzzaman Khan, M. Razzaque
Now–a-days, fungal infections of the skin are very common in Bangladesh as like as the other countries in the world. Surprisingly, these infections have become very difficult to treat and cure permanently. We know that, skin takes part in many vital functions of the body as it is the largest organ. It maintains the temperature & salt-water balance and protects the internal organs from the external noxious environment. It is also involved in synthesis and excretion of many vital constituents of the body. Damage to the skin by various noxious stimuli like burns, injuries or infections are major concerns in Dermatology. At present, most of the health care providers in Bangladesh are facing serious problems due to the emergence of resistance to available anti-fungal drugs. The nature is considered as the hidden treasure of medicines. Innumerable natural compounds are used worldwide due to their acceptable margin of efficacy, safety & cost. The present review is involved to find out 24 (twenty four) bioactive plants used in rural Bangladesh as folklore medicines to treat various skin diseases including the fungal ones. Further researches are recommended immediately to identify, separate and assess the antifungal efficacy of bioactive principles present in these plants. Successful screening of the resistant fungal strains and their interaction with these bioactive compounds would also be an interesting era of study. Hopefully, the most promising compounds would be developed as newer medicines and manufactured commercially to combat the increasing burden of fungal epidemics. KYAMC Journal Vol. 13, No. 02, July 2022: 115-119
{"title":"A Review to Search Novel Antifungal Principles from Bioactive Plants: The Hidden Treasure","authors":"Akm Shahidur Rahman, Nishat Parvin, Md. Moniruzzaman Khan, M. Razzaque","doi":"10.3329/kyamcj.v13i2.61342","DOIUrl":"https://doi.org/10.3329/kyamcj.v13i2.61342","url":null,"abstract":"Now–a-days, fungal infections of the skin are very common in Bangladesh as like as the other countries in the world. Surprisingly, these infections have become very difficult to treat and cure permanently. We know that, skin takes part in many vital functions of the body as it is the largest organ. It maintains the temperature & salt-water balance and protects the internal organs from the external noxious environment. It is also involved in synthesis and excretion of many vital constituents of the body. Damage to the skin by various noxious stimuli like burns, injuries or infections are major concerns in Dermatology. At present, most of the health care providers in Bangladesh are facing serious problems due to the emergence of resistance to available anti-fungal drugs. The nature is considered as the hidden treasure of medicines. Innumerable natural compounds are used worldwide due to their acceptable margin of efficacy, safety & cost. The present review is involved to find out 24 (twenty four) bioactive plants used in rural Bangladesh as folklore medicines to treat various skin diseases including the fungal ones. Further researches are recommended immediately to identify, separate and assess the antifungal efficacy of bioactive principles present in these plants. Successful screening of the resistant fungal strains and their interaction with these bioactive compounds would also be an interesting era of study. Hopefully, the most promising compounds would be developed as newer medicines and manufactured commercially to combat the increasing burden of fungal epidemics.\u0000KYAMC Journal Vol. 13, No. 02, July 2022: 115-119","PeriodicalId":17948,"journal":{"name":"KYAMC Journal","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82111610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-05DOI: 10.3329/kyamcj.v13i2.61337
M. Rouf, Tanvirul Hasan, S. Alam, Abdul Hanif Tablu, K. Hasina, A. Moniruddin
Background: Although the global number of newborn deaths declined from 5 million (1990) to 2.4 million (2020), children face the greatest risk of death within their first 28 days of life. Dhaka Medical College Hospital (DMCH) is the biggest tertiary hospital in Bangladesh serving all incoming patients free of cost. Objectives: We studied here the clinical patterns and outcomes of neonatal surgeries in DMCH from July 2014 to June 2016. Materials and Methods: This prospective descriptive study included 500 neonates with surgical problems who had attended from July 2014 to June 2016. Data were collected at admission and thereafter by predesigned data collection sheet. Results: Male female ratio was 1.5: 1. Majority of the neonates (346) presented during the first week of life (69.2%). Presented within 1 hour to 28 days (mean 7.1 days ± SD 8.8), weighing 1.5 - 5.0 kilogram (mean 2.6 in kg ± SD 0.5). Surgical indications in order of sequences were Neonatal Intestinal Obstruction (NIO), gastroschisis, omphalocele, abscess/cellulitis, hydronephrosis, congenital diaphragmatic hernia, Tracheo esophageal atresia or fistula (TEF), bladder exstrophy, malignancy, Infantile Hypertrophic Pyloric Stenosis (IHPS), cloacal exstrophy, neonatal injury, patent urachus, prune belly syndrome, amniotic band syndrome. NIO was in the form of Anorectal Malformations (ARM), Hirschsprung disease, septicemia, intestinal atresia, meconium ileus, volvulus neonatorum, multiple congenital anomalies, obstructed inguinal hernia. Total 384 patients were managed surgically. 125 (25.0%). 33 (6.6%) died preoperatively and 92 (18.4%) died postoperatively. Conclusion: Early diagnosis, resuscitation, skilled staff, ICU facilities etc. are crucial for the best outcomes of neonatal surgical problems. KYAMC Journal Vol. 13, No. 02, July 2022: 86-93
{"title":"Clinical Pattern and Outcome of Neonates with Surgical Problems in Dhaka Medical College Hospital","authors":"M. Rouf, Tanvirul Hasan, S. Alam, Abdul Hanif Tablu, K. Hasina, A. Moniruddin","doi":"10.3329/kyamcj.v13i2.61337","DOIUrl":"https://doi.org/10.3329/kyamcj.v13i2.61337","url":null,"abstract":"Background: Although the global number of newborn deaths declined from 5 million (1990) to 2.4 million (2020), children face the greatest risk of death within their first 28 days of life. Dhaka Medical College Hospital (DMCH) is the biggest tertiary hospital in Bangladesh serving all incoming patients free of cost.\u0000Objectives: We studied here the clinical patterns and outcomes of neonatal surgeries in DMCH from July 2014 to June 2016.\u0000Materials and Methods: This prospective descriptive study included 500 neonates with surgical problems who had attended from July 2014 to June 2016. Data were collected at admission and thereafter by predesigned data collection sheet.\u0000Results: Male female ratio was 1.5: 1. Majority of the neonates (346) presented during the first week of life (69.2%). Presented within 1 hour to 28 days (mean 7.1 days ± SD 8.8), weighing 1.5 - 5.0 kilogram (mean 2.6 in kg ± SD 0.5). Surgical indications in order of sequences were Neonatal Intestinal Obstruction (NIO), gastroschisis, omphalocele, abscess/cellulitis, hydronephrosis, congenital diaphragmatic hernia, Tracheo esophageal atresia or fistula (TEF), bladder exstrophy, malignancy, Infantile Hypertrophic Pyloric Stenosis (IHPS), cloacal exstrophy, neonatal injury, patent urachus, prune belly syndrome, amniotic band syndrome. NIO was in the form of Anorectal Malformations (ARM), Hirschsprung disease, septicemia, intestinal atresia, meconium ileus, volvulus neonatorum, multiple congenital anomalies, obstructed inguinal hernia. Total 384 patients were managed surgically. 125 (25.0%). 33 (6.6%) died preoperatively and 92 (18.4%) died postoperatively.\u0000Conclusion: Early diagnosis, resuscitation, skilled staff, ICU facilities etc. are crucial for the best outcomes of neonatal surgical problems.\u0000KYAMC Journal Vol. 13, No. 02, July 2022: 86-93","PeriodicalId":17948,"journal":{"name":"KYAMC Journal","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89846902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-05DOI: 10.3329/kyamcj.v13i2.61340
Md. Golam Sarower Rayhan, M. Nurunnabi, Shahnaz Kabir, B. Alam
Background: Thalassaemia is an emerging global public health concern. It is considering as a rapidly growing major health burden for low- and middle income countries. The prevalence of thalassaemia is increasing in Bangladesh, indicates that thalassemia will be an emerging health burden for our country. Objective: To assess the level of mental stress among parents with a thalassemic child. Materials and Methods: A cross-sectional study was conducted among the 141 parents with a thalassemic child in the purposively selected two hospitals’ Dhaka Shishu Hospital and Bangladesh Thalassemia Hospital in Dhaka. ‘Parental stress scale’ (PSS) was used to measure the level of stress. Results: The mean age of the parents was 36.2±8.8 years and nearly two-thirds (63.8%) of them were aged below 40 years. Almost half of the participants (49.6%) and their spouses (59.6%) completed their education upto the higher secondary level. The mean monthly family income was 27,113.5±46,696.9 taka. More than half of the parent’s (53.2%) had low level of mental stress. The education, occupation, monthly family income, presence of >1 thalassaemic child in family, received blood from a voluntary blood donor, normal growth of thalassaemic child and history of thalassaemic child death were significantly associated with the level of mental stress by PSS scores of the parents (p<0.05). The level of stress was low among the parents, whose educational level was up to primary level (68.6%), occupation as a business (68.4%), monthly family income ≥50,001 taka (85.7%), presence of >1 beta thalassaemia major child (47.6%), received blood from a voluntary blood donor (50.0%), had a history of normal growth of thalassaemic child (60.4%) and had no history of thalassaemic child death (50.0%). Conclusion: Existence of the children with thalassemia in a family cause massive stress and anxiety for parents. Psychological supports for them are essential as a part of comprehensive medical care along with clinical management of the thalassemic child. The burden of disease can be reduced through effective preventive approaches, such as carrier screening, prenatal counseling and diagnosis. KYAMC Journal Vol. 13, No. 02, July 2022: 102-107
{"title":"Mental Stress of Parents Having Thalassemic Children","authors":"Md. Golam Sarower Rayhan, M. Nurunnabi, Shahnaz Kabir, B. Alam","doi":"10.3329/kyamcj.v13i2.61340","DOIUrl":"https://doi.org/10.3329/kyamcj.v13i2.61340","url":null,"abstract":"Background: Thalassaemia is an emerging global public health concern. It is considering as a rapidly growing major health burden for low- and middle income countries. The prevalence of thalassaemia is increasing in Bangladesh, indicates that thalassemia will be an emerging health burden for our country.\u0000Objective: To assess the level of mental stress among parents with a thalassemic child.\u0000Materials and Methods: A cross-sectional study was conducted among the 141 parents with a thalassemic child in the purposively selected two hospitals’ Dhaka Shishu Hospital and Bangladesh Thalassemia Hospital in Dhaka. ‘Parental stress scale’ (PSS) was used to measure the level of stress.\u0000Results: The mean age of the parents was 36.2±8.8 years and nearly two-thirds (63.8%) of them were aged below 40 years. Almost half of the participants (49.6%) and their spouses (59.6%) completed their education upto the higher secondary level. The mean monthly family income was 27,113.5±46,696.9 taka. More than half of the parent’s (53.2%) had low level of mental stress. The education, occupation, monthly family income, presence of >1 thalassaemic child in family, received blood from a voluntary blood donor, normal growth of thalassaemic child and history of thalassaemic child death were significantly associated with the level of mental stress by PSS scores of the parents (p<0.05). The level of stress was low among the parents, whose educational level was up to primary level (68.6%), occupation as a business (68.4%), monthly family income ≥50,001 taka (85.7%), presence of >1 beta thalassaemia major child (47.6%), received blood from a voluntary blood donor (50.0%), had a history of normal growth of thalassaemic child (60.4%) and had no history of thalassaemic child death (50.0%).\u0000Conclusion: Existence of the children with thalassemia in a family cause massive stress and anxiety for parents. Psychological supports for them are essential as a part of comprehensive medical care along with clinical management of the thalassemic child. The burden of disease can be reduced through effective preventive approaches, such as carrier screening, prenatal counseling and diagnosis.\u0000KYAMC Journal Vol. 13, No. 02, July 2022: 102-107","PeriodicalId":17948,"journal":{"name":"KYAMC Journal","volume":"252 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75761215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The cardiac operative procedure has a significant relationship with acute onset of pain. After cardiac surgery, pain has been managed with the help of opiate analgesics. Objective: To analyze the adverse effects of postoperative multimodal analgesia after cardiac surgery concerning the physical and specific biochemical parameters of undergoing surgery patients. Materials & Methods: It was a single-center, prospective study where patients were approached on the day before their cardiac surgery. A total of 120 post-cardiac operative surgery patients at Khwaja Yunus Ali Medical College Hospital, Sirajganj were included for this study purpose. Results: In first group, three types of analgesia were used in 60 patients and in second group, five types of analgesia were used in another 60 patients. About 76.7% were male and mean age was 45.73 (± 11.3) years. Fentanyl was used for all patients followed by paracetamol (96.7%), diclofenac (83.3%), tramadol (16.7%), and pethidine (3.3%). Drug-induced nausea and vomiting were found in 76.7%and 66.7% patients respectively followed by drowsiness (36.7%) and vertigo (20.0%). Conclusion: In patients undergoing cardiac surgery, a multimodal regimen offered better analgesia. Furthermore, nausea and vomiting complaints were reduced significantly in the multimodal group. KYAMC Journal Vol. 13, No. 02, July 2022: 94-97
{"title":"Study on Using Multimodal Analgesia in Postoperative Cardiac ICU","authors":"Md Mezanur Rahman, Mohd Iqbal Kabir, Miraj Hossain, Md Rafiqul Islam, Md Muzibur Rahman, Md. Lutfar Rahman, Md Fahad Hossain","doi":"10.3329/kyamcj.v13i2.61338","DOIUrl":"https://doi.org/10.3329/kyamcj.v13i2.61338","url":null,"abstract":"Background: The cardiac operative procedure has a significant relationship with acute onset of pain. After cardiac surgery, pain has been managed with the help of opiate analgesics.\u0000Objective: To analyze the adverse effects of postoperative multimodal analgesia after cardiac surgery concerning the physical and specific biochemical parameters of undergoing surgery patients.\u0000Materials & Methods: It was a single-center, prospective study where patients were approached on the day before their cardiac surgery. A total of 120 post-cardiac operative surgery patients at Khwaja Yunus Ali Medical College Hospital, Sirajganj were included for this study purpose.\u0000Results: In first group, three types of analgesia were used in 60 patients and in second group, five types of analgesia were used in another 60 patients. About 76.7% were male and mean age was 45.73 (± 11.3) years. Fentanyl was used for all patients followed by paracetamol (96.7%), diclofenac (83.3%), tramadol (16.7%), and pethidine (3.3%). Drug-induced nausea and vomiting were found in 76.7%and 66.7% patients respectively followed by drowsiness (36.7%) and vertigo (20.0%).\u0000Conclusion: In patients undergoing cardiac surgery, a multimodal regimen offered better analgesia. Furthermore, nausea and vomiting complaints were reduced significantly in the multimodal group.\u0000KYAMC Journal Vol. 13, No. 02, July 2022: 94-97","PeriodicalId":17948,"journal":{"name":"KYAMC Journal","volume":"35 5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77554637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-05DOI: 10.3329/kyamcj.v13i2.61332
Anupam Das, A. Basak, Choity Malakar, Md. Zulfikar Ali
Background: Somatoform and dissociative disorder categories have emerged from a common root, there was no apparent anatomical and physiological basis and which had a temporal relationship to a precipitating event. Objectives: To evaluate and compare of stressful life events of the patients of somatoform disorders and dissociative disorders. Materials and methods: This was a comparative cross-sectional study carried out in the outpatient department of Psychiatry, Khwaja Yunus Ali Medical College, Sirajganj. The study populations were 100 somatoform disorder and 100 dissociative disorder patients. Data were collected by pre-designed data collection sheet. Then data were edited, cleaned and analyzed. Results: Stressful life events were observed to be significantly more frequent in both the groups. Family conflicts (29%) and sexual problem (16%) were more common in the somatoform disorder group of patients but marital conflict (26%) and death of the close family member (11%) were more common in the dissociative disorder group of patients. This study shows that dissociative disorder patients were observed to experience a variety of life events more than somatoform disorder group of patients. Conclusion: The stressful life events were reported more in dissociative disorder. The results suggest a substantial involvement of stressful life events in genesis of somatoform disorders and dissociative disorders, although no significant difference is noticed. KYAMC Journal Vol. 13, No. 02, July 2022: 63-65
{"title":"Effects of Stressful Life Events on Somatoform and Dissociative Disorders","authors":"Anupam Das, A. Basak, Choity Malakar, Md. Zulfikar Ali","doi":"10.3329/kyamcj.v13i2.61332","DOIUrl":"https://doi.org/10.3329/kyamcj.v13i2.61332","url":null,"abstract":"Background: Somatoform and dissociative disorder categories have emerged from a common root, there was no apparent anatomical and physiological basis and which had a temporal relationship to a precipitating event.\u0000Objectives: To evaluate and compare of stressful life events of the patients of somatoform disorders and dissociative disorders.\u0000Materials and methods: This was a comparative cross-sectional study carried out in the outpatient department of Psychiatry, Khwaja Yunus Ali Medical College, Sirajganj. The study populations were 100 somatoform disorder and 100 dissociative disorder patients. Data were collected by pre-designed data collection sheet. Then data were edited, cleaned and analyzed.\u0000Results: Stressful life events were observed to be significantly more frequent in both the groups. Family conflicts (29%) and sexual problem (16%) were more common in the somatoform disorder group of patients but marital conflict (26%) and death of the close family member (11%) were more common in the dissociative disorder group of patients. This study shows that dissociative disorder patients were observed to experience a variety of life events more than somatoform disorder group of patients.\u0000Conclusion: The stressful life events were reported more in dissociative disorder. The results suggest a substantial involvement of stressful life events in genesis of somatoform disorders and dissociative disorders, although no significant difference is noticed.\u0000KYAMC Journal Vol. 13, No. 02, July 2022: 63-65","PeriodicalId":17948,"journal":{"name":"KYAMC Journal","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81240164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-05DOI: 10.3329/kyamcj.v13i2.61341
Abu Masud Al Mamun, Md amanur Rasul, Uttam Karmekar, P. K. Das, Arun Kumar Paul
Background: Urethral stricture is a chronic and common urological problem in Bangladesh and its management poses a big challenge to urologists. Surgical treatment of urethral stricture diseases is a continuously evolving process, and the superiority of one technique over another has yet to be clearly demonstrated. Urethrotomy is the most commonly used technique but long term results are not satisfactory. Long penile urethral strictures are best treated by substitution urethroplasty. The ideal graft material for substitution urethroplasty is constantly evolving. Buccal mucosa produces excellent result but is associated with many long term donor site complications. Lingual mucosa is an alternative donor site for graft urethroplasty and achieved good functional and aesthetic results. Materials & Methods: A hospital based prospective study was conducted in the department of urology, Dhaka Medical College Hospital from July 2016 to March 2017. Total 40 patients were included in this study. They were divided in two groups, group 1 was treated by lingual mucosal graft and group 2 was treated by buccal mucosal graft. All patients were followed up for six months noting pre and post-operative maximum urine flow rate (Qmax), voiding time and complications at both urethroplasty and donor site. Results: There were no significant differences in overall operative success rate between two groups of patients. But complications at donor site were higher in group 2 patients. Conclusion: Lingual mucosal graft urethroplasty may be preferred to buccal mucosa in anterior urethral stricture as it is easy to harvest and is associated with less short and long term donor site complications without significant difference in operative success rate. KYAMC Journal Vol. 13, No. 02, July 2022: 108-114
背景:尿道狭窄在孟加拉国是一种慢性和常见的泌尿系统问题，其管理对泌尿科医生提出了很大的挑战。尿道狭窄疾病的外科治疗是一个不断发展的过程，一种技术比另一种技术的优越性尚未得到明确的证明。尿道切开术是最常用的方法，但长期效果不理想。长阴茎尿道狭窄最好采用替代尿道成形术。替代尿道成形术的理想移植材料在不断发展。颊黏膜移植效果良好，但有许多长期的供区并发症。舌黏膜是移植尿道成形术的另一供体，具有良好的功能和美观效果。材料与方法:2016年7月至2017年3月在达卡医学院附属医院泌尿外科进行了一项以医院为基础的前瞻性研究。本研究共纳入40例患者。分为两组，组1采用舌黏膜移植治疗，组2采用颊黏膜移植治疗。所有患者均随访6个月，观察术前和术后最大尿流率(Qmax)、排尿时间以及输尿管成形术和供体部位并发症。结果:两组患者手术总成功率无显著差异。但2组患者供体部位并发症发生率较高。结论:舌粘膜移植尿道成形术优于颊粘膜移植尿道成形术，因为舌粘膜移植容易摘取，且短期和长期供区并发症少，手术成功率无显著差异。KYAMC学报，Vol. 13, No. 02, July 2022: 108-114
{"title":"Comparison between Lingual Mucosal Graft Urethroplasty and Buccal Mucosal Graft Urethroplasty in The Management of Anterior Urethral Stricture.","authors":"Abu Masud Al Mamun, Md amanur Rasul, Uttam Karmekar, P. K. Das, Arun Kumar Paul","doi":"10.3329/kyamcj.v13i2.61341","DOIUrl":"https://doi.org/10.3329/kyamcj.v13i2.61341","url":null,"abstract":"Background: Urethral stricture is a chronic and common urological problem in Bangladesh and its management poses a big challenge to urologists. Surgical treatment of urethral stricture diseases is a continuously evolving process, and the superiority of one technique over another has yet to be clearly demonstrated. Urethrotomy is the most commonly used technique but long term results are not satisfactory. Long penile urethral strictures are best treated by substitution urethroplasty. The ideal graft material for substitution urethroplasty is constantly evolving. Buccal mucosa produces excellent result but is associated with many long term donor site complications. Lingual mucosa is an alternative donor site for graft urethroplasty and achieved good functional and aesthetic results.\u0000Materials & Methods: A hospital based prospective study was conducted in the department of urology, Dhaka Medical College Hospital from July 2016 to March 2017. Total 40 patients were included in this study. They were divided in two groups, group 1 was treated by lingual mucosal graft and group 2 was treated by buccal mucosal graft. All patients were followed up for six months noting pre and post-operative maximum urine flow rate (Qmax), voiding time and complications at both urethroplasty and donor site.\u0000Results: There were no significant differences in overall operative success rate between two groups of patients. But complications at donor site were higher in group 2 patients.\u0000Conclusion: Lingual mucosal graft urethroplasty may be preferred to buccal mucosa in anterior urethral stricture as it is easy to harvest and is associated with less short and long term donor site complications without significant difference in operative success rate.\u0000KYAMC Journal Vol. 13, No. 02, July 2022: 108-114","PeriodicalId":17948,"journal":{"name":"KYAMC Journal","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84871349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-05DOI: 10.3329/kyamcj.v13i2.61336
Gazi Ikhtiar Ahmed, Md Maruf Hasan Zaman, Md Abdulla Hil Kafi, N. Islam, Syed Atiqur Rahman
Background: A patient’s medical record should provide accurate information on who the patient is and who provided health care; what, when, why and how services were provided; and the outcome of care and treatment. Objectives: The study was conducted with the objective of revealing the condition of medical audit of the inpatient department in Rangpur medical college hospital in short duration of time. Materials and Methods: A cross-sectional descriptive study was done in inpatient department in Rangpur Medical College & Hospital. This was carried out on 160 medical documents, interview with providers, record of hospital statistics & personal observation on physical facilities in indoor at the time of the study to find out in what extend medical record exist in patient service. Results: In inpatient department of Hospital, the generation and location of the form in all wards were inpatient, administrative office & type of the forms were mixed pattern. There was no electronic record system in the medicine department. They consisted of forms, sheet & register khata. Medical records were not filled of in most of the cases. A hundred and sixty records were checked where most of the components were not filled up completely (above 30% not filled up). The recording of hospital statistics were satisfactory and maintained regularly in the inpatient department. Conclusion: The standard of documentation by providers in inpatient medical records was found to be acceptable, with improvements required in a number of specific items. KYAMC Journal Vol. 13, No. 02, July 2022: 81-85
{"title":"An Evaluation of Medical Record Keeping Status to Assess Health Care Facilities for Hospitalized Patients In A Tertiary Care Hospital","authors":"Gazi Ikhtiar Ahmed, Md Maruf Hasan Zaman, Md Abdulla Hil Kafi, N. Islam, Syed Atiqur Rahman","doi":"10.3329/kyamcj.v13i2.61336","DOIUrl":"https://doi.org/10.3329/kyamcj.v13i2.61336","url":null,"abstract":"Background: A patient’s medical record should provide accurate information on who the patient is and who provided health care; what, when, why and how services were provided; and the outcome of care and treatment.\u0000Objectives: The study was conducted with the objective of revealing the condition of medical audit of the inpatient department in Rangpur medical college hospital in short duration of time.\u0000Materials and Methods: A cross-sectional descriptive study was done in inpatient department in Rangpur Medical College & Hospital. This was carried out on 160 medical documents, interview with providers, record of hospital statistics & personal observation on physical facilities in indoor at the time of the study to find out in what extend medical record exist in patient service.\u0000Results: In inpatient department of Hospital, the generation and location of the form in all wards were inpatient, administrative office & type of the forms were mixed pattern. There was no electronic record system in the medicine department. They consisted of forms, sheet & register khata. Medical records were not filled of in most of the cases. A hundred and sixty records were checked where most of the components were not filled up completely (above 30% not filled up). The recording of hospital statistics were satisfactory and maintained regularly in the inpatient department.\u0000Conclusion: The standard of documentation by providers in inpatient medical records was found to be acceptable, with improvements required in a number of specific items.\u0000KYAMC Journal Vol. 13, No. 02, July 2022: 81-85","PeriodicalId":17948,"journal":{"name":"KYAMC Journal","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89010316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-05DOI: 10.3329/kyamcj.v13i2.61334
Muhammad Shahidul Islam, Mohammed Mejbahuddin Mia, R. Hussain, S. Hoque, Fahmeeda Tasnim
Background: Public awareness-creating activities have been taking place to promote blood donation but the units still do not match the yearly demands for blood. Prevalence of transfusion transmissible infection also happens to be a problem. Objective: To study the difference of ratio in between male and female donors as well as the trend of transfusion transmissible diseases. Materials and Methods: The present study has 56,557 blood donors over fourteen long years (2008 – 2021) by the Department of Transfusion Medicine at Khwaja Yunus Ali Medical College & Hospital (KYAMCH). Result: The donor medical assessment was passed by 56,557 people over 14 years; the number of females were 4,661 in compare to 51,896 males. Regarding the results of TTI screening, it is to be noted that only 688 positive cases were found among 56,557 people – implying only about 1.2% of the potential donor population being rejected. Conclusion: The data analysis has shed some light on the demography of donors and also Transfusion Transmissible Infections (TTIs) trends over the study period. KYAMC Journal Vol. 13, No. 02, July 2022: 72-75
{"title":"Differences in Gender and Trends of Transfusion Transmissible Infections Among Blood Donors at a Tertiary Hospital in Bangladesh","authors":"Muhammad Shahidul Islam, Mohammed Mejbahuddin Mia, R. Hussain, S. Hoque, Fahmeeda Tasnim","doi":"10.3329/kyamcj.v13i2.61334","DOIUrl":"https://doi.org/10.3329/kyamcj.v13i2.61334","url":null,"abstract":"Background: Public awareness-creating activities have been taking place to promote blood donation but the units still do not match the yearly demands for blood. Prevalence of transfusion transmissible infection also happens to be a problem.\u0000Objective: To study the difference of ratio in between male and female donors as well as the trend of transfusion transmissible diseases.\u0000Materials and Methods: The present study has 56,557 blood donors over fourteen long years (2008 – 2021) by the Department of Transfusion Medicine at Khwaja Yunus Ali Medical College & Hospital (KYAMCH).\u0000Result: The donor medical assessment was passed by 56,557 people over 14 years; the number of females were 4,661 in compare to 51,896 males. Regarding the results of TTI screening, it is to be noted that only 688 positive cases were found among 56,557 people – implying only about 1.2% of the potential donor population being rejected.\u0000Conclusion: The data analysis has shed some light on the demography of donors and also Transfusion Transmissible Infections (TTIs) trends over the study period.\u0000KYAMC Journal Vol. 13, No. 02, July 2022: 72-75","PeriodicalId":17948,"journal":{"name":"KYAMC Journal","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84571336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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