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Comparative Study on Evaluation of Results of DHS/PFN in Management of Intertrochanteric Fracture of Femur
Full text linkIntroduction: 38–50% of all femur fractures and 5–20% of fractures in their entirety are intertrochanteric fractures. The prevalence of these fractures is 180/10000, making them prevalent in the senior population. While intramedullary devices like PFN are thought to be superior implants for unstable intertrochanteric fractures, dynamic hip screws are still the gold standard for managing intertrochanteric fractures. Their function in treating these fractures remains questionable.
Materials and Methods: The study was conducted on 100 patients with intertrochanteric fracture of femur attending the outpatient and emergency department of National Institute of Traumatology & Orthopedic Rehabilitation (NITOR), Dhaka between May 2019 to April 2020. Following a clinical and radiological evaluation, the patients were split into two groups at random, A and B. Patients in group A received treatment by ORIF using a dynamic hip screw, whereas patients in group B received treatment via closed/open reduction and internal fixation with PFN. The working proforma below contains the following information of the patient: personal information, clinical findings, radiological findings, and follow-up findings. The outcomes were assessed and contrasted.
Results: The mean age in both the groups was 58.88 ± 15.76 years, In DHS group, there were 8(16%) females and 42(84%) males. In PFN group, there were 15(30%) females and 35(70%) males. There was a male preponderance in both the groups in comparison to the females. In PFN group, there were 24(48%) patients who injured because of fall, while 26(52%) were injured due to RTA. In PFN group, higher number of fall patients were there, while in DHS group, higher number of RTA patients were there. The comparison of mean blood loss in both the groups showed a statistically significant difference (P < 0.0001), with a higher mean blood loss in DHS group in comparison to PFN group. In DHS group, 48(96%) patients had no complications, 2(4%) had DVT and 1(2%) had cut out of screw, 3(6%) had infection. In PFN group, 2(4%) had infection, 48(96%) shows no complication. The difference in mean union time was significant (P < 0.0001) with a higher union time in DHS group in comparison to PFN group. DHS group functional outcome assessment by Harris Hip score, there were 22(44%) patients had Excellent and the PFN group functional outcome assessment by Harris Hip score, there were 26(52%) patients had Excellent.
Conclusion: PFN provides stability and aids in biological reduction. Excessive collapse and limb shortening are avoided by PFN. As a result, it aids in obtaining a positive functional outcome overall. PFN is a load-bearing implant that provides stability to the fracture area both proximally and distally. As such, it is a more biomechanically sound implant option for fixing peri-trochanteric femoral fractures. When it comes to bleeding during surgery and the early stages of recovery, PFN is a superior implant option than DHS. Consequently, we support the use of PFN rather than DHS in intertrochanteric fractures, with the exception of fractured trochanteric entry points for the PFN
Outcome of Removal of Biliary Stent Prior to Pancreaticoduodenectomy
Full text linkBackground: Obstructive jaundice is the commonest manifestation in patients with periampullary carcinoma. Pancreaticodudenctomy is the only curative procedure for resectable tumor. But raised serum bilirubin level may cause the postoperative events. For that reason, preoperative biliary drainage is an important step to reduce the overall postoperative complications. The main aim of this study is to assess the rate of post-operative complications, length of hospital stays and death between patients undergoing pancreaticoduduenectomy with or without removal of biliary stent. Methodology: This prospective cross-sectional study was conducted into department of Surgery and Hepatobiliary, pancreatic and liver transplantation Surgery of BSMMU from July,2017 to June 2018. Initially all the patient diagnosed as periampullary carcinoma and underwent preoperative biliary drainage were enrolled in the study by purposive sampling. Surgery was planned 4-6 weeks after stenting. The analysis was done by student’s t test here. Cross tabulation and chi square test were done to analyze the categorical data. p value was considered as significant at <0.05. Data analysis was done using the software statistical package for social science (SPSS-23. Results: Patients with biliary stent in situ till pancreaticoduodenectomy was significantly associated with positive bile culture (P=0.025) and, E. coli (45.45%) is the most common organism. Post-operative woundinfection was significantly high (p=0.035) in Group A than Group B. From the point of view of postoperative morbidity Group B showed better results than Group A. Microscopic findings of bile duct showed disruption of mucosal epithelium in all 11 (100%) patients in Group A in contrast it was in 3 (33.33%) patients in Group B, which was statistically significant (P value <0.05). Conclusion: Removal of biliary stent before surgery who already underwent preoperative biliary decompression for improvement of liver function showed relatively better outcome after surgery in comparison to those patients in whom pancreaticoduodenectomy was done with keeping stent in situ
Profile of Hepatic Dysfunction in Dengue Patients of Western Rural Maharashtra
Full text linkTitle: PROFILE OF HEPATIC DYSFUNCTION IN DENGUE PATIENTS OF WESTERN RURAL MAHARASHTRA Background of the study: Dengue fever is benign syndrome caused by several arthropod-borne viruses. It is transmitted to human by bites of infected female Aedes mosquitoes . Levels of transaminase are raised; a higher increase in SGOT than SGPT suggests dengue rather than other virus infections. Aim and objectives:To correlate the serum aminotransferase levels in patients with dengue infection with dengue serology, presenting to the pediatrics department of Pravara Rural Hospital, Loni. Material and methods : This descriptive longitudinal hospital-based study was conducted from January 2022 to October 2022. Results :A total of 100 patients were included in the study who were having dengue fever. The patients included were 1 to 12 years of age.Maximum number of patients were seen in the age group of 1-5 years.Included 64 males and 36 females, with male to female ratio was 1.7:1. Conclusion: As this study and statistics points out that there is a significant association with biomarkers such as SGOT & SGPT; as that patients under careful supervision and management can able to prevent them from progressing to severe dengue. As early alterations of these biochemical markers can predict progressing to SEVERE DENGUE in patients with acute fever caused by dengue
Comparative Evaluation of Transmittance Between Zirconium Di-Oxide Crown and Human Natural Tooth Crown: An In-Vitro Study
Full text linkBackground: The transmittance/translucency of a dental crown is a crucial property that affects the color of a dental crown. The characteristics of the crown material and background contrast affect the transmittance of the value of the crown material.
Objective: This study was aimed to evaluate and compare the transmittance between zirconium dioxide crown and natural human tooth crown.
Methods: An in-vitro study was conducted at Department of Prosthodontics, Bangabandhu Sheikh Mujib Medical University. A total of 20 specimens/crowns prepared with zirconium di-oxide and 20 specimens/crowns of natural human tooth crown. A total of 40 crowns/specimens were included for testing transmittance/ translucency individually. The thickness of outer layer of these specimens was uniform in accordance with the American Dental Association (ADA) specifications. The zirconia crown preparation on model was done. The outer layer of both group of crown specimens was 2 mm in thickness. Fourier-transform infrared spectroscopy (FTIR) test was used to evaluate the transmittance/ translucency value of samples. This test was carried out using the FTIR test at Chemical Engineering Department of Bangladesh University of Engineering and Technology. A FTIR test was used to measure the contrast ratio, which is indicative of transmittance level. The transmittance of the specimens was recorded with the help check list. The transmittance values were analyzed by One Sample T Test to determine the mean value with its standard deviation for each group. To compare between two groups, P≤0.05 was considered.
Results: The mean transmittance value (409.4±.7) cm-1 wavelength of natural tooth crown is less than zirconium di-oxide crown (467.2±.8) cm-1 wave length when intact form of sample was tested and it was significant (P 0.001). In addition, the mean of transmittance value (560.6±) cm-1 wavelength of natural tooth crown was lower than zirconium di-oxide crown (596.18) cm-1 wavelength when grinded form of sample was tested and it was also significant (P 0.001).
Conclusion: To conclude, the zirconia crown in both intact and grinded form showed more transmittance/ translucency when compared with the natural human tooth crown or enamel. So, it is expected that this study will help the dental professional to choose the zirconia as crown material to fulfill the patient’s satisfaction
Tuberculosis and Superior Vena Cava Obstruction
No full textSuperior Vena Cava (SVC) obstruction is a rare but serious medical condition characterized by the blockage of the second largest vein in the human body, leading to various symptoms including swelling in the upper body, shortness of breath, and dizziness. Causes of SVC obstruction range from malignancies such as lymphoma and breast cancer to infectious diseases like tuberculosis, along with other factors like blood clots and constrictive pericarditis. Diagnosis typically involves clinical examination and imaging studies like MRI, CT, and venography. A proposed classification system categorizes symptoms into hemodynamic, respiratory, and neurological manifestations, aiding in treatment urgency determination. Management focuses on relieving the blockage and addressing the underlying cause, which may include antibiotics, anticoagulants, chemotherapy, or radiotherapy. We present a case study of a 40-year-old male with neck pain and dizziness, ultimately diagnosed with sub-acute thrombosis of the internal jugular veins leading to SVC compression, potentially due to tuberculosis. This case underscores the importance of considering tuberculosis as a differential diagnosis, particularly in endemic regions, facilitating timely and appropriate treatment interventions
Amyloidosis - A rare case report in Bangladesh
Full text linkAmyloidosis is a disorder where there is extracellular deposition of insoluble protein in different tissues and organs. AL amyloidosis is the commonest type where monoclonal immunoglobin light chain secreted by plasma cells is deposited as amyloid fibrils in tissues which can lead to multiorgan failure. This disorder is a rare and complex condition characterized by the deposition of amyloid proteins in tissues, leading to their dysfunction. The condition may be localized or systemic, with a wide range of clinical manifestations depending on the organs involved, such as the heart, kidneys, liver, gastrointestinal tract, and nervous system. We report a 50-year-old lady with multiple joint pain and multiple papulovesicular lesion around oral cavity, eye, around anus and macroglossia. She was diagnosed as a case of AL amyloidosis by clinical features and skin biopsy. She was put on oral lenalidomide and dexamethasone. This type of papulovesicular lesion is rare form of skin manifestation in AL amyloidosis. The importance of early recognition, multidisciplinary management, and improved healthcare resources in addressing rare diseases like amyloidosis in low-resource settings such as Bangladesh. Awareness campaigns and capacity building in healthcare systems are vital for timely diagnosis and intervention
Advancing Academic Careers: Exploring the Influence of Article Publication on Promotion, Emphasizing Patience, Perseverance, and Time-Valuing Journals
Full text linkPublishing research articles is a crucial aspect of academic advancement, showcasing research productivity, credibility, and impact. However, the publication process can be demanding and time-consuming, requiring authors to navigate through challenges, handle rejections, and continually improve their work. Moreover, the choice of journal can significantly influence the publishing experience, particularly regarding promptness, clear communication, and efficient peer review. Journals that value authors\u27 time aim to minimize delays, provide transparent timelines, and recognize authors\u27 contributions. Understanding the interplay between publication, patience, perseverance, and journals that prioritize authors\u27 time contributes to a deeper comprehension of academic promotion dynamics and provides valuable insights for researchers aiming to advance their careers.
 
Progression & prognosis of Covid-19 patients having diabetes mellitus
Full text linkBackground: Diabetes patients experience a variety of internal health issues, including immune deficiencies, inflammatory storms, hyperglycemia, coagulation risks, and elevated levels of ACE2 receptors. They also suffer from various illnesses like high blood pressure, cardiovascular disease, kidney problems, visual issues, and a host of others. None of these factors raise the chance of contracting SARS-CoV-2. However, once they are infected, the condition worsens to the point that the death rate is high.
Objective: This study aimed to examine the severity of symptoms between COVID-19 participants with and without diabetes.
Methods: A total of 347 patients with confirmed SARS CoV-2 were selected by a purposive sampling method for this retrospective, single-center study that took place from June 1, 2020, to August 31, 2020, at the Department of Medicine, TMSS Medical College, and Rafatullah Community Hospital, Bogura, Bangladesh. We investigated and compared their sociodemographic information, clinical traits, morbidities, lab results, and CT scan results. The study was approved by the ethical committee of the mentioned hospital. All of the patients tested positive for COVID 19. Patients with a COVID 19 negative result and those younger than 18 years old were, however, eliminated based on the study\u27s exclusion criteria.
Results: Diabetes patients experienced worse hospital outcomes, including a death rate of 19.4% (p=0.002163), and longer hospital stays (p = 0.0001) compared to non-diabetic patients. Additionally, diabetic patients got more oxygen therapy (32 hours, p 0.05), injectable antiviral drugs (161, p 0.05), and low molecular weight heparin (105, p 0.05) than non-diabetics. These findings suggest that diabetes affects the prognosis of COVID 19.
Conclusion: Diabetes worsens the prognosis and is a risk factor for the Covid-19 symptoms\u27 quick progression. Therefore, individuals with Covid-19 infection and diabetes should receive additional attention because they could deteriorate at any time.
 
Clinical Outcome of Alloantibody in Thalassemia Patient
Full text linkBackground: Thalassemia is a common hemoglobin ailment in Bangladesh and one of the major public health complications. Although blood transfusions are lifesavers for thalassemia patients, they may be associated with some complications especially erythrocyte alloimmunization. The development of alloantibodies may complicate the management of patients with thalassemia. An extended antigenic matching may decrease the risk of alloimmunization.
Objective: The aim of the study was to evaluate the outcome of alloantibody in thalassemia patient.
Methods: This is an observational study. This study was carried out on 105 population including male and female patients in the Department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University, Chittagong Medical College Hospital and MH Samorita Hospital & Medical College, Bangladesh. The duration of the period from January 2022 to December 2022. The period from Data was entered in MS Excel and Statistical analysis was done using SPSS-24.
Results: The total study population was 105 patients aged 10 – 30 years, 49(46.67%) were ≤10 years, 19(18.09%) were 11-19 years, 20(19.04%) were 20-29 years and 17(16.19%) were ≥30years. And sex distribution of the population where, 28(26.66%) were male and 77(73.33%) were Female.
Conclusion: Thalassemia patients may benefit from receiving red blood cells (RBC) transfusions based on extended antigen matching as demonstrated by the lack of new alloantibodies. There is relatively high rate of alloimmunization in the patients and red cell alloimmunization should not be overlooked in patients receiving regular blood transfusions
Evaluation and Outcome of Surgical Management of Plateau Fracture- A Study in Shaheed Monsur Ali Medical College, Dhaka, Bangladesh
Full text linkIntroduction: Orthopaedic tibial plateau fractures are common. These fractures affect the knee\u27s articular tibia. Plateau fractures may be simple or complicated. Skeletal and ligamentous injuries determine stability.
Methodology: The Department of Orthopaedic and Trauma Surgery at Shaheed Monsur Ali Medical College and Hospital in Dhaka, Bangladesh, performed this prospective study from June to December 2022. This study operated on 22 tibial plateau fracture patients. These individuals have significant injuries from motor vehicle accidents, falls, attacks, etc. These patients were assessed pre- and post-surgery. Schatzker, Hohl-Moore, and AO categorised these examples.
Results: 22 individuals had tibial plateau fractures. Patients averaged 45,4 years old. RTA damaged most patients. Schatzker\u27s classifications called for CRIF, percutaneously cannulated cancellous screws, ORIF with buttress plate with or without bone transplantation, and external fixation for the identified fractures. Post-surgery range of motion started early. Weightless for 6-8 weeks. Weight bearing is delayed until fracture union or 12 weeks. POP casts immobilise unstable fractures for 3-6 weeks. After union, locomotion, weight bearing, and knee range of motion were excellent to very good. Fractures healed as expected. The series showed no non-union. Union averaged 14 weeks (10-22 weeks). Due to the severity of the injuries and infections, ten of the twenty-two surgical cases had excellent outcomes, whereas one had a poor result.
Conclusion: As car accidents grow, so do high-velocity tibial plateau fractures. In depressed and displaced fractures, surgery may stabilise the knee.