Abstract not available Journal of Surgical Sciences (2018) Vol. 22 (2) : 77-78
外科科学杂志(2018)Vol. 22 (2): 77-78
{"title":"Medical Teacher","authors":"S. Sultana","doi":"10.3329/jss.v22i2.44068","DOIUrl":"https://doi.org/10.3329/jss.v22i2.44068","url":null,"abstract":"Abstract not available \u0000Journal of Surgical Sciences (2018) Vol. 22 (2) : 77-78","PeriodicalId":33248,"journal":{"name":"Journal of Surgical Sciences","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91192204","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}
N. Akhter, Abu Khaled Mohammad Lqbal, Md. Mahbubur Rahman, Joydeep Datta Gupta, A. Alam
Background: Idiopathic granulomatous mastitis is a rare disease of the breast. Clinically and radiologically it may mimic breast carcinoma. To date, there is no agreed gold standard treatment for IGM. The clinical management often starts with tests to eliminate microbial infection and when microbial infection can be ruled out, long-term oral steroid treatment or surgery is administered. Objective: To see the response of different treatment options of idiopathic granulomatous mastitis. Methods: This is a retrospective study involved 50 patients who were diagnosed with IGM and were treated in our institution between January 2009 to December 2016. Results: The mean age of patients was 34.3 years. Breast lump was the most common presentation. The right breast was affected in 30 cases & left breast 20 cases. 4 patients were pregnant at the time of presentation. Lactation within 6 months of presentation was documented in 4patients.45 patients used contraceptives pills. A clinical suspicion of malignancy was present in 17 cases. Mammography was performed in 20 patients and showed focal asymmetrical dense lesions in 9, well-circumscribed opacity in 8, speculated lesion in 1, and was normal in 2. Fine-needle aspiration was performed in 40 patients. Wide local excision was the mainstay of treatment. One patient underwent mastectomy due to recurrence and the final histology confirmed idiopathic granulomatous mastitis with no evidence of malignancy. 12 patients developed recurrence after a mean follow-up of 31.2 months. Conclusion: IGM is not so rare disease in our country. Clinical, radiologic, and even cytological findings are sometimes confused with malignancy. Adequate Surgical treatment as well as adjuvant therapeutic treatment are necessary. Knowledge, awareness and co-operation among surgeons and pathologist should also be strengthen to avoid unnecessary misdiagnosis and treatment. Journal of Surgical Sciences (2017) Vol. 21 (2): 89-93
{"title":"Management of idiopathic granulomatous mastitis: dilema in diagnosis and management","authors":"N. Akhter, Abu Khaled Mohammad Lqbal, Md. Mahbubur Rahman, Joydeep Datta Gupta, A. Alam","doi":"10.3329/jss.v21i2.43915","DOIUrl":"https://doi.org/10.3329/jss.v21i2.43915","url":null,"abstract":"Background: Idiopathic granulomatous mastitis is a rare disease of the breast. Clinically and radiologically it may mimic breast carcinoma. To date, there is no agreed gold standard treatment for IGM. The clinical management often starts with tests to eliminate microbial infection and when microbial infection can be ruled out, long-term oral steroid treatment or surgery is administered. \u0000Objective: To see the response of different treatment options of idiopathic granulomatous mastitis. \u0000Methods: This is a retrospective study involved 50 patients who were diagnosed with IGM and were treated in our institution between January 2009 to December 2016. \u0000Results: The mean age of patients was 34.3 years. Breast lump was the most common presentation. The right breast was affected in 30 cases & left breast 20 cases. 4 patients were pregnant at the time of presentation. Lactation within 6 months of presentation was documented in 4patients.45 patients used contraceptives pills. A clinical suspicion of malignancy was present in 17 cases. Mammography was performed in 20 patients and showed focal asymmetrical dense lesions in 9, well-circumscribed opacity in 8, speculated lesion in 1, and was normal in 2. Fine-needle aspiration was performed in 40 patients. Wide local excision was the mainstay of treatment. One patient underwent mastectomy due to recurrence and the final histology confirmed idiopathic granulomatous mastitis with no evidence of malignancy. 12 patients developed recurrence after a mean follow-up of 31.2 months. \u0000Conclusion: IGM is not so rare disease in our country. Clinical, radiologic, and even cytological findings are sometimes confused with malignancy. Adequate Surgical treatment as well as adjuvant therapeutic treatment are necessary. Knowledge, awareness and co-operation among surgeons and pathologist should also be strengthen to avoid unnecessary misdiagnosis and treatment. \u0000Journal of Surgical Sciences (2017) Vol. 21 (2): 89-93","PeriodicalId":33248,"journal":{"name":"Journal of Surgical Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83813713","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: Haemorrhoidectomy is a surgical excision and removal of the hemorrhoid used primarily only in severe cases. There are many different types of haemorrhoidectomy like open haemorrhoidectomy and stapled haemorrhoidectomy. Objective: To compare the outcome of stapled haemorrhoidectomy and traditional open haemorrhoidectomy. Methods: This is a cross sectional study of 72 cases who underwent open and stapled haemorrhoidectomy operation for symptomatic 2nd, 3rd and 4th degree hemorrhoids. Binomial probability pre-posttest were used for statistical analysis, p value less than 0.05 was taken as significant. Results: : Among 72 patients, 34 patients of conventional haemorrhoidectomy and 38 of stapled haemorrhoidectomy at 3 months post-surgery in conventional group 1 patient was unsatisfied, 12 patients were satisfied and 4 patients stated their condition good. In stapled group 14 patients stated their condition excellent and 5 patients stated their condition good. Statistical analysis shows that level of satisfaction at 3 months post-surgery in conventional group and stapled group was statistically significant(p-value<.001). Conclusion: Stapled haemorrhoidectomy is a relatively new procedure. Stapled haemorrhoidectomy is a safe procedure, less pain and disabled than the conventional haemorrhoidectomy. Journal of Surgical Sciences (2017) Vol. 21 (2): 99-104
{"title":"Comparison of outcome between traditional open haemorrhoidectomy and stapled haemorrhoidectomy operation","authors":"Farjana Haque Shumi, Md Omar Ali, Md. Akram Hossain","doi":"10.3329/jss.v21i2.43917","DOIUrl":"https://doi.org/10.3329/jss.v21i2.43917","url":null,"abstract":"Background: Haemorrhoidectomy is a surgical excision and removal of the hemorrhoid used primarily only in severe cases. There are many different types of haemorrhoidectomy like open haemorrhoidectomy and stapled haemorrhoidectomy. \u0000Objective: To compare the outcome of stapled haemorrhoidectomy and traditional open haemorrhoidectomy. Methods: This is a cross sectional study of 72 cases who underwent open and stapled haemorrhoidectomy operation for symptomatic 2nd, 3rd and 4th degree hemorrhoids. Binomial probability pre-posttest were used for statistical analysis, p value less than 0.05 was taken as significant. \u0000Results: : Among 72 patients, 34 patients of conventional haemorrhoidectomy and 38 of stapled haemorrhoidectomy at 3 months post-surgery in conventional group 1 patient was unsatisfied, 12 patients were satisfied and 4 patients stated their condition good. In stapled group 14 patients stated their condition excellent and 5 patients stated their condition good. Statistical analysis shows that level of satisfaction at 3 months post-surgery in conventional group and stapled group was statistically significant(p-value<.001). \u0000Conclusion: Stapled haemorrhoidectomy is a relatively new procedure. Stapled haemorrhoidectomy is a safe procedure, less pain and disabled than the conventional haemorrhoidectomy. \u0000Journal of Surgical Sciences (2017) Vol. 21 (2): 99-104","PeriodicalId":33248,"journal":{"name":"Journal of Surgical Sciences","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80249546","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}
Md. Mahmudul Islam, Khondkar A K Azad, M. A. Islam, Rivu Chakraborty
Background: Chest trauma is responsible for 50% of deaths due to trauma. This kind of death usually occurs immediately after trauma. Various therapeutic options have been reported for management of chest injuries like clinical observation, thoracocentesis, tube thoracostomy and open thoracotomy. Methods: This is an observational study carried out in the department of Casualty, Chittagong Medical College Hospital over a period of one year (from April 2015 to March 2016). All the patients (both male and female) admitted in the casualty units within the specified period were included in this study. Result: The mean age was found 37.7±18.1 years and male-female ratio was 11.8:1. Almost one third (35.7%) patients were affected by road traffic accident. 42(27.2%) patients were found open pneumothorax followed by rib fracture-41(26.6%), haemopneumothorax-31(20.1%), pneumothorax- 14(9%), haemothorax-12(7.8%), chest wall injury-6(3.9%), tension pneumothorax-5(3.2%), and flail chest-3(1.9%). More than three fourth (80.5%) patients were managed by tube thoracostomy followed by 28(18.2%) observation and 2(1.3%) ventilatory support. No thoracotomy was done in emergency department. Re-insertion of ICT was done in 6(4.7%) patients. More than two third (68.2%) patients recovered well, 43(27.9%) patients developed complications and 6(3.9%) patients died. Conclusion: Most of the patients were in 3rd decade with male predominance. Road traffic accident was the commonest cause and open pneumothorax was the commonest chest trauma. Three-fourths were managed by tube thoracostomy. Nearly one third of the patients had developed complications and about four percent of patients died. Journal of Surgical Sciences (2019) Vol. 23 (1) : 19-24
{"title":"Chest Trauma Evaluation and Outcome of Management in a Tertiary Hospital-One Year Experience","authors":"Md. Mahmudul Islam, Khondkar A K Azad, M. A. Islam, Rivu Chakraborty","doi":"10.3329/jss.v23i1.44240","DOIUrl":"https://doi.org/10.3329/jss.v23i1.44240","url":null,"abstract":"Background: Chest trauma is responsible for 50% of deaths due to trauma. This kind of death usually occurs immediately after trauma. Various therapeutic options have been reported for management of chest injuries like clinical observation, thoracocentesis, tube thoracostomy and open thoracotomy. \u0000Methods: This is an observational study carried out in the department of Casualty, Chittagong Medical College Hospital over a period of one year (from April 2015 to March 2016). All the patients (both male and female) admitted in the casualty units within the specified period were included in this study. \u0000Result: The mean age was found 37.7±18.1 years and male-female ratio was 11.8:1. Almost one third (35.7%) patients were affected by road traffic accident. 42(27.2%) patients were found open pneumothorax followed by rib fracture-41(26.6%), haemopneumothorax-31(20.1%), pneumothorax- 14(9%), haemothorax-12(7.8%), chest wall injury-6(3.9%), tension pneumothorax-5(3.2%), and flail chest-3(1.9%). More than three fourth (80.5%) patients were managed by tube thoracostomy followed by 28(18.2%) observation and 2(1.3%) ventilatory support. No thoracotomy was done in emergency department. Re-insertion of ICT was done in 6(4.7%) patients. More than two third (68.2%) patients recovered well, 43(27.9%) patients developed complications and 6(3.9%) patients died. \u0000Conclusion: Most of the patients were in 3rd decade with male predominance. Road traffic accident was the commonest cause and open pneumothorax was the commonest chest trauma. Three-fourths were managed by tube thoracostomy. Nearly one third of the patients had developed complications and about four percent of patients died. \u0000Journal of Surgical Sciences (2019) Vol. 23 (1) : 19-24","PeriodicalId":33248,"journal":{"name":"Journal of Surgical Sciences","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84987831","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: Stapled Hemorrhoidopexy (SH) is a new technique with less pain than conventional hemorrhoidectomy and can be used in the management of second, third and fourth degree hemorrhoidal disease. Objective: To show the effectiveness of Stapled Hemorrhoidopexy as a treatment option of symptomatic hemorrhoid. Methods: This is an observational study. The medical records of 72 patients who had under gone Stapled Hemorrhoidopexy for symptomatic hemorrhoid disease from July 2011 to June 2013 in BIRDEM General Hospital under a same surgeon were evaluated. Data regarding postoperative pain, early and late postoperative outcome were recorded. Patient's satisfaction assessed at 18 months follow up. Results: The study included 72 patients (50 men, 22 women) between 22 - 74 years of age (median age 39 years). The operating time was around 35 minutes. The median hospital stay was 40 hours (11- 72 hours). Early complications were fecal urgency (13.8%), urinary retention (22%), and rectal bleeding (2.77%). Late complication was pruritus ani (12.5%), thrombosis external hemorrhoids (1.38%), staple line stenosis (1.38%), recurrent hemorrhoid (2.77%), anal fissure (2.77%), and persistent mucous discharge (5.55%). The recurrence rate was 2.77% at 18 months follow up. Conclusion: Stapled hemorrhoidopexy can be safely performed with low recurrence and complication rates while offering a relatively painless postoperative period for the patient. Journal of Surgical Sciences (2017) Vol. 21 (2): 65-69
{"title":"Promising new technique for treatment of hemorrhoids- Our experience","authors":"S. K. Mondal, Sharmistha Roy, M. S. Uddin","doi":"10.3329/jss.v21i2.43898","DOIUrl":"https://doi.org/10.3329/jss.v21i2.43898","url":null,"abstract":"Background: Stapled Hemorrhoidopexy (SH) is a new technique with less pain than conventional hemorrhoidectomy and can be used in the management of second, third and fourth degree hemorrhoidal disease. \u0000Objective: To show the effectiveness of Stapled Hemorrhoidopexy as a treatment option of symptomatic hemorrhoid. \u0000Methods: This is an observational study. The medical records of 72 patients who had under gone Stapled Hemorrhoidopexy for symptomatic hemorrhoid disease from July 2011 to June 2013 in BIRDEM General Hospital under a same surgeon were evaluated. Data regarding postoperative pain, early and late postoperative outcome were recorded. Patient's satisfaction assessed at 18 months follow up. \u0000Results: The study included 72 patients (50 men, 22 women) between 22 - 74 years of age (median age 39 years). The operating time was around 35 minutes. The median hospital stay was 40 hours (11- 72 hours). Early complications were fecal urgency (13.8%), urinary retention (22%), and rectal bleeding (2.77%). Late complication was pruritus ani (12.5%), thrombosis external hemorrhoids (1.38%), staple line stenosis (1.38%), recurrent hemorrhoid (2.77%), anal fissure (2.77%), and persistent mucous discharge (5.55%). The recurrence rate was 2.77% at 18 months follow up. \u0000Conclusion: Stapled hemorrhoidopexy can be safely performed with low recurrence and complication rates while offering a relatively painless postoperative period for the patient. \u0000Journal of Surgical Sciences (2017) Vol. 21 (2): 65-69","PeriodicalId":33248,"journal":{"name":"Journal of Surgical Sciences","volume":"99 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75452481","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}
Abstract not available Journal of Surgical Sciences (2018) Vol. 22 (1): 9-10
外科杂志(2018)Vol. 22 (1): 9-10
{"title":"Surgical error","authors":"A. Sharfuzzaman","doi":"10.3329/jss.v22i1.44007","DOIUrl":"https://doi.org/10.3329/jss.v22i1.44007","url":null,"abstract":"Abstract not available \u0000Journal of Surgical Sciences (2018) Vol. 22 (1): 9-10","PeriodicalId":33248,"journal":{"name":"Journal of Surgical Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90141890","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}
-. Md Fardhus, A. Sharfuzzaman, Md. Nayeem Dewan, Joy Zakharia Rab
Background: Appendicitis may be associated with morbidity and occasionally mortality. If failed to diagnose early, the situation may become more complicated. Objective: To validate the role of Alvarado score in diagnosis of acute appendicitis. Methods: A total of 282 patients with clinically diagnosed acute appendicitis were included in this study. Patients were examined thoroughly, investigated and managed accordingly. The relevant data collected and analyzed. Results: Out of 282 patients, surgical procedures were performed in 59.57% of the patients. The overall negative Appendectomy rate was 9.52%, and the percentage of Positive Predictive Value (PPV) for Alvarado score was 92.26%. Conclusion: Our study validates the Alvarado score as fast, simple and reliable diagnostic tool for acute appendicitis. Journal of Surgical Sciences (2017) Vol. 21 (2): 94-98
{"title":"Role of alvarado score in diagnosis of acute appendicitis","authors":"-. Md Fardhus, A. Sharfuzzaman, Md. Nayeem Dewan, Joy Zakharia Rab","doi":"10.3329/jss.v21i2.43916","DOIUrl":"https://doi.org/10.3329/jss.v21i2.43916","url":null,"abstract":"Background: Appendicitis may be associated with morbidity and occasionally mortality. If failed to diagnose early, the situation may become more complicated. \u0000Objective: To validate the role of Alvarado score in diagnosis of acute appendicitis. \u0000Methods: A total of 282 patients with clinically diagnosed acute appendicitis were included in this study. Patients were examined thoroughly, investigated and managed accordingly. The relevant data collected and analyzed. Results: Out of 282 patients, surgical procedures were performed in 59.57% of the patients. The overall negative Appendectomy rate was 9.52%, and the percentage of Positive Predictive Value (PPV) for Alvarado score was 92.26%. \u0000Conclusion: Our study validates the Alvarado score as fast, simple and reliable diagnostic tool for acute appendicitis. \u0000Journal of Surgical Sciences (2017) Vol. 21 (2): 94-98","PeriodicalId":33248,"journal":{"name":"Journal of Surgical Sciences","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83566597","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}
The laparoscopic cholecystectomy is considered the gold standard for the treatment of benign gall bladder disease, which is associated with an increased incidence of biliary injuries. These types of injuries are multicausal, and anatomical variations or anatomical perception errors are the most common risk factors. Iatrogenic bile duct injuries are complex alterations and constitute one of the most serious complications of a cholecystectomy and require a comprehensive approach, proper drainage and timely referral to adequate treatment to improve long-term prognosis. Reconstruction and treatment techniques have been evolving. The selection of adequate treatment will impact on the patient, s quality of life. Journal of Surgical Sciences (2017) Vol. 21 (2): 110-114
{"title":"Classification and Management of iatrogenic bile duct injury","authors":"Mohammad Ali, Kazi lsrat Jahan","doi":"10.3329/jss.v21i2.43920","DOIUrl":"https://doi.org/10.3329/jss.v21i2.43920","url":null,"abstract":"The laparoscopic cholecystectomy is considered the gold standard for the treatment of benign gall bladder disease, which is associated with an increased incidence of biliary injuries. These types of injuries are multicausal, and anatomical variations or anatomical perception errors are the most common risk factors. Iatrogenic bile duct injuries are complex alterations and constitute one of the most serious complications of a cholecystectomy and require a comprehensive approach, proper drainage and timely referral to adequate treatment to improve long-term prognosis. Reconstruction and treatment techniques have been evolving. The selection of adequate treatment will impact on the patient, s quality of life. \u0000Journal of Surgical Sciences (2017) Vol. 21 (2): 110-114","PeriodicalId":33248,"journal":{"name":"Journal of Surgical Sciences","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79069056","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}
Kazi Mazharul Lslam, Md Aminul Lslam, Mashfique Ahmed Bhuiyan, Azizur Rahman Muyaz, Mohammad Masum
Background: Acute pancreatitis (AP) is an acute inflammation of the pancreas and clinical evolution is frequently unpredictable. Numerous predictive markers have been studied to assess severity in AP, including clinical assessment, clinical-physiological scoring systems, imaging techniques, and biochemical markers in different body fluids. Objective: This study was done to see the association between level of CRP and severity of acute pancreatitis. Methods: 50 patients diagnosed as acute pancreatitis based on operational definition admitted in Dhaka Medical College Hospital was included in the study. Patients' admission date back from 1ST August, 2016 to 31december, 2015. Conservative management started from the date of admission as per standard conservative management protocol. Patients were monitored by RANSON scoring system and categorized as mild if RANSON score is <3 and categorized as severe if the score is ≥3. At the same time serum CRP level was measured on day 2, 3 and 7. Then the correlation between the severity of the disease and measures of CRP was established by unpaired t test and x2 test. Results: Over 6 months of study period 50 patients were treated for pancreatitis in different medical and surgical unit of Dhaka Medical College Hospital. Etiological analysis revealed mostly caused by biliary disease (40%) followed by idiopathic, alcoholic, post ERCP and post traumatic. Based on RANSON score about 34 patient developed mild acute pancreatitis and 16 patient developed severe acute pancreatitis. Then CRP value of this two groups was compared on day 2, 3, 7 by unpaired t test with P value<.001 in all 3 days. ROC curve was plotted to determine specificity and sensitivity with a cut off value of CRP 132mg/l. Sensitivity and specificity was 75% and 55.8% accordingly. Conclusion: In a patient with acute pancreatitis the use of RANSON scoring system is not always possible as many of the investigation are not easily available in our set up. In our study we have found that serum CRP level is significantly (cut off value 132) higher in patient with sever acute pancreatitis. This will allow high proportion of patients with mild disease to be managed in low-cost hospital beds. Acute pancreatitis is an important cause of hospital admission with acute abdomen. It is responsible for significant morbidity and also mortality in patients Journal of Surgical Sciences (2017) Vol. 21 (2): 80-84
背景:急性胰腺炎(AP)是胰腺的一种急性炎症，临床发展往往难以预测。已经研究了许多预测标志物来评估AP的严重程度，包括临床评估、临床生理评分系统、成像技术和不同体液中的生化标志物。目的:研究CRP水平与急性胰腺炎严重程度的关系。方法:选取达卡医学院附属医院经手术诊断为急性胰腺炎的50例患者作为研究对象。患者入院时间为2016年8月1日至2015年12月31日。保守管理从入院之日起按标准保守管理方案开始。采用RANSON评分系统对患者进行监测，RANSON评分<3分为轻度，≥3分为重度。同时于第2、3、7天测定血清CRP水平。然后采用非配对t检验和x2检验建立疾病严重程度与CRP测定值的相关性。结果:在6个月的研究期间，50例胰腺炎患者在达卡医学院医院不同内科和外科接受治疗。病因分析显示，主要由胆道疾病引起(40%)，其次为特发性、酒精、ERCP后和创伤后。根据RANSON评分，轻度急性胰腺炎34例，重度急性胰腺炎16例。比较两组患者第2、3、7天的CRP值，采用非配对t检验，P值<。总共3天。绘制ROC曲线，以CRP的截断值132mg/l确定特异性和敏感性。敏感性为75%，特异性为55.8%。结论:在急性胰腺炎患者中，使用RANSON评分系统并不总是可能的，因为许多调查在我们的设置中不容易获得。在我们的研究中，我们发现重症急性胰腺炎患者血清CRP水平明显升高(cut off value 132)。这将使很大比例的轻病患者能够在低成本的医院病床上得到治疗。急性胰腺炎是急腹症住院的重要原因。它是导致患者显著发病率和死亡率的原因外科科学杂志(2017)Vol. 21 (2): 80-84
{"title":"C -reactive protein in assessment of severity acute pancreatitis","authors":"Kazi Mazharul Lslam, Md Aminul Lslam, Mashfique Ahmed Bhuiyan, Azizur Rahman Muyaz, Mohammad Masum","doi":"10.3329/jss.v21i2.43902","DOIUrl":"https://doi.org/10.3329/jss.v21i2.43902","url":null,"abstract":"Background: Acute pancreatitis (AP) is an acute inflammation of the pancreas and clinical evolution is frequently unpredictable. Numerous predictive markers have been studied to assess severity in AP, including clinical assessment, clinical-physiological scoring systems, imaging techniques, and biochemical markers in different body fluids. \u0000Objective: This study was done to see the association between level of CRP and severity of acute pancreatitis. Methods: 50 patients diagnosed as acute pancreatitis based on operational definition admitted in Dhaka Medical College Hospital was included in the study. Patients' admission date back from 1ST August, 2016 to 31december, 2015. Conservative management started from the date of admission as per standard conservative management protocol. Patients were monitored by RANSON scoring system and categorized as mild if RANSON score is <3 and categorized as severe if the score is ≥3. At the same time serum CRP level was measured on day 2, 3 and 7. Then the correlation between the severity of the disease and measures of CRP was established by unpaired t test and x2 test. \u0000Results: Over 6 months of study period 50 patients were treated for pancreatitis in different medical and surgical unit of Dhaka Medical College Hospital. Etiological analysis revealed mostly caused by biliary disease (40%) followed by idiopathic, alcoholic, post ERCP and post traumatic. Based on RANSON score about 34 patient developed mild acute pancreatitis and 16 patient developed severe acute pancreatitis. Then CRP value of this two groups was compared on day 2, 3, 7 by unpaired t test with P value<.001 in all 3 days. ROC curve was plotted to determine specificity and sensitivity with a cut off value of CRP 132mg/l. Sensitivity and specificity was 75% and 55.8% accordingly. Conclusion: In a patient with acute pancreatitis the use of RANSON scoring system is not always possible as many of the investigation are not easily available in our set up. In our study we have found that serum CRP level is significantly (cut off value 132) higher in patient with sever acute pancreatitis. This will allow high proportion of patients with mild disease to be managed in low-cost hospital beds. Acute pancreatitis is an important cause of hospital admission with acute abdomen. It is responsible for significant morbidity and also mortality in patients \u0000Journal of Surgical Sciences (2017) Vol. 21 (2): 80-84","PeriodicalId":33248,"journal":{"name":"Journal of Surgical Sciences","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75419485","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}
K. Alam, Md Shah Alam Sarker, Md Khaled Hasan, Prawesh Maharjan
Pneumothorax and pneumoperitoneum caused by penetrating chest injury are rare. Pneumoperitoneum following trauma usually indicates the presence of a perforated intraabdominal hollow viscous. Other causes of pneumoperitoneum are through the abdominal wall, through the diaphragm, through female genital tract and through retroperitoneum. Here we report an unusual case of pneumothorax and pneumoperitoneum caused by penetrating injury in the posterior aspect of chest in a young male patient of 33 years who presented to us with chest & abdominal pain & breathlessness. The diagnosis was made on clinical & radiological examination. Tube thoracostomy was done followed by laparotomy and repair of diaphragmatic & splenic injury. Post operative recovery was uneventful & the patient was discharged on 9th p.o.d after removal of thoracostomy tube & wound stiches. Journal of Surgical Sciences (2018) Vol. 22 (1) : 67-69
{"title":"Pneumothorax and pneumoperitoneum caused by penetrating chest injury","authors":"K. Alam, Md Shah Alam Sarker, Md Khaled Hasan, Prawesh Maharjan","doi":"10.3329/jss.v22i1.44030","DOIUrl":"https://doi.org/10.3329/jss.v22i1.44030","url":null,"abstract":"Pneumothorax and pneumoperitoneum caused by penetrating chest injury are rare. Pneumoperitoneum following trauma usually indicates the presence of a perforated intraabdominal hollow viscous. Other causes of pneumoperitoneum are through the abdominal wall, through the diaphragm, through female genital tract and through retroperitoneum. Here we report an unusual case of pneumothorax and pneumoperitoneum caused by penetrating injury in the posterior aspect of chest in a young male patient of 33 years who presented to us with chest & abdominal pain & breathlessness. The diagnosis was made on clinical & radiological examination. Tube thoracostomy was done followed by laparotomy and repair of diaphragmatic & splenic injury. Post operative recovery was uneventful & the patient was discharged on 9th p.o.d after removal of thoracostomy tube & wound stiches. \u0000Journal of Surgical Sciences (2018) Vol. 22 (1) : 67-69","PeriodicalId":33248,"journal":{"name":"Journal of Surgical Sciences","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78428351","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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