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Fracture of radial neck and proximal ulna with medial displacement of the radial shaft
Get PDFIntroduction: Radial neck injuries are reasonably common, and when present as isolated injuries with minimal displacement or angulation, a good outcome is anticipated. Elbow injuries are common in children but radial neck fractures are relatively rare (5% to 10%) in paediatric elbow fractures. Objective: To assess the fracture of radial neck and proximal ulna with medial displacement of the radial shaft. Materials and Methods: This was a retrospective study conducted at Dept. of Ortho-Surgery, Sheikh Sayera Khatun Medical College Hospital, Gopalgonj, Bangladesh from January 2018 to December 2021. Medical records of ten patients who had displaced radial neck fractures treated at our Hospital. Ten patients who had displaced radial neck fractures (Judet type III and type IV) treated. Patients were assessed for functional outcome by Mayo elbow performance score (MEPS), the Tibone and Stoltz functional criteria, and for complications with the average follow-up of four years (range: six months to seven years). Patients were assessed for functional outcome by Mayo elbow performance score (MEPS), the Tibone and Stoltz functional criteria, and for complications with the average follow-up. Results: The mean age of the patients was 9.12±2.2 years (range: 4 to 14 years). Eight (80%) patients were males and two (20%) patients were females. The right side was the most commonly injured side (right at 68% and left at 32%). Six (60%) cases were of Judet type III and (40%) cases were of Judet type IV. The mean fracture angulation of the series was 56.5 degrees (range 33.2 degrees to 79.2 degrees). Four patients had isolated radial neck fractures and four patients had associated proximal ulna fractures and one patient had associated posterolateral elbow dislocation. Among two patients treated with percutaneous pin leverage and intramedullary nailing by the Metaizeau technique, one patient had an excellent outcome, and the other had a good outcome. Among four cases treated with open reduction and K-wire fixation, two patients had good outcomes, one patient had a fair outcome, and one patient had a poor outcome. Conclusion: The majority of moderately to severely displaced pediatric radial neck fractures which need intervention can be managed by the closed reduction technique of Metaizeau with or without pin leverage with excellent to good functional outcomes at short-term follow-up. Some cases need open reduction which also has good to fair outcomes
Health care seeking behaviour among the rural adult women of Srinagar Upazilla of Munshigonj, Bangladesh
Get PDFThere has been an increasing availability and accessibility of modern health services in rural Bangladesh over the past decades. However, previous studies on the health care seeking behaviour of the rural people of Bangladesh were based on limited number of factors (Variables) focusing mainly on the rural adult people both male and female. This cross sectional descriptive study was conducted to determine the health care seeking behavior among the rural adult women. Two hundred and seventy adult women from several villages of Srinagar Upazila under the district of Munshigonj were interviewed for the study. Data were collected by face to face interview form the respondents through a semi-structured questionnaire by purposive sampling method. From this study it was found that the mean age of the respondents was 26.94 years with standard deviation +11.53 years. Majority of them were married (55.55%). Most of them were Muslims (93.33%). Among 270 respondents 30.00% were of H.S.C level and 15.55% were illiterate. Among the husbands of the married women proportion of illiteracy was 35.85%. About 22.22% respondents had family income below 5000 tk. per month and 67.78% of the respondents had nuclear family. The most common disease they suffered from was fever (16.22%). The other mentionable diseases were Joint pain 9.46%, Cough and Cold 8.11%, Peptic ulcer 6.76% and Hypertension 4.05%. Most of the respondents (26.66%) went to Thana Health Complex for seeking for health care. Another 16.67% women went to Private MBBS Doctor. Only 1.11% went to Community Clinic. Forty percent (40%) of the diseased women went to Local health center because of reliability and 21.11% went there as treatment cost is low. Almost all (98.89%) of the respondents replied that they should go to a qualified (MBBS) doctor. 54.44% rural adult women of Srinagar were satisfied about the treatment facilities in Local Govt. Hospital/THC. Majority (43.33%) of the women were referred to specialized hospital in Dhaka after treatment failure in Primary site. During illness majority of the respondents (34.44%) took decision themselves for seeking health care. 20% women took decision combined with their husband. During the illness of their children 28.23% women went to Local Govt. Hospital/THC and 22.35% went to MBBS Doctor Privately. Majority of the respondents (30%) thought that they could get modern treatment from THC/Govt. Hospital and 25.55% thought that it could be found from Private MBBS Doctor. Among the 270 respondents 54.44% were willing to participate in local health awareness program. In my study I have found association between the economic status of the respondents and their satisfaction about the treatment facilities in Local Govt. Hospital. There was a significant relationship between the educational level of the respondents and their willingness to participate in local health awareness program. The respondents who were of HSC level of education were mostly (81.48%) willing to participate in such health program. In my study the findings could not be compared to similar type of findings of other studies, because there were limited references. The association between economic status of the respondents and satisfaction about the treatment facilities can be evaluated from further in-depth study
Evaluation of illizarov technic in treating tibial open fractures: An observational study
Get PDFIntroduction: Illizarov technique is a versatile method of treating open tibial fractures after debridement and open reduction. Tibial open fractures are usually classified into Type I, II, IIIA, IIIB and IIIC. Illizarov method has many advantages and features for such fracture treatment. But in Bangladesh, we have not enough research-oriented information regarding this treatment method.
Aim of the study: This study aimed to assess the Ilizarov technique in treating tibial open fractures.
Methods: This observational prospective study was conducted in the Department of Orthopedics of TMSS Medical College, Bogura, Bangladesh and 3 associated private clinics during the period from January 2018 to December 2021. In total 23 patients with tibial open fractures were confirmed as the study subjects. Before starting this 3 year in3-yeartion, proper written consent of the participants was taken and this study was approved by the ethical committee of the mentioned hospital and clinics. A semi-structured; pre-designed questionnaire was used in collecting patient data. All the data were processed, analyzed and disseminated by using MS Office and SPSS version 23.
Results: In this study, we found highest 65% of participants were injured from road traffic accidents (RTA) followed by 26% from general falls and the rest 9% from a sports injury as the mode of injury. The total treatment duration with the fixator was 12-23 weeks with an average of 16 weeks. The operation time ranged from 90 minutes to 120 minutes. As per the Karlstrom and Olerud criteria, the highest 70% of patients got ‘excellent’ results. Besides this, 17%, 9% and 4% of patients got ‘good’, ‘fair’ and ‘poor’ results respectively.
Conclusion: In our study, we found some excellent features the of Ilizarov induced method in the treatment of open fractures of tibia. We would like recommend more use of Ilizthe arov technic in the field of Orthopaedics
Coronal approach for Management of Craniomaxillofacial Trauma: A case report and Literature Review
Get PDFThe coronal approach with its modifications is considered to be the most versatile approach for skull and midface surgeries. It was first proposed by Tessier and since then has been used in head and neck trauma and reconstructive procedures. It gives the best aesthetic outcome since the surgical scar is hidden within the hair line. Although it has gained great momentum given its range of access to the forehead and most of the upper midface, it has certain drawbacks. We present a case of a patient with frontal bone fracture secondary to trauma where a coronal approach was used for internal fixation of fractures. This article also gives a brief description about the surgical procedure, merits, demerits and clinical application
A case report Early recognition and Timely intervention saved a life-A case report.
No full textA 56-year-old male patient was brought to our Emergency room with a history of unconsciousness after a minor accident in front of our hospital. On arrival the patient was unresponsive without pulse-was in cardiac arrest, a code blue was activated and CPR started immediately, cardiac rhythm showed shockable rhythm Ventricular fibrillation, the patient has managed as per ACLS protocols for shockable rhythm-ventricular fibrillation. After 12 minutes of hard work achieved ROSC, the airway was secured, ECG showed acute anterior wall ST elevation MI, the patient was shifted to Cath lab immediately coronary angiography showed complete LAD block stunts placed, shifted to ICU extubated on next evening and discharged from hospital with no neurological deficit on 4th day.
KEY WORDS: Unresponsive, CPR, cardiac arrest, Code Blue, Shockable rhythm, coronary angiography
Fibrinogen levels amongst patients suffering from vasculopathy- IHD/Stroke/DVT: A novel risk factor
Get PDFRecently, research is underway and many other factors are being identified to mention Fibrinogen (Fi) as a likely novel risk factor for vasculopathies. It is Likely that with higher fibrinogen levels in the blood, local deposition of fibrin may be more pronounced and fibrinolysis poorer so it helps in thrombosis. Hence, this study was undertaken to study the prevalence of new risk factor (Fibrinogen) in the general population (both young and old) and also to find out the difference in prevalence rates (if any) in the young (less than 45 years of age) and in the elderly (more than 45 years of age).
This was the case-control study done in the cardiology unit of Bharti Hospital, Pune. All the patients diagnosed as cases of vasculopathies especially IHD/ Stroke/ DVT (n=75) were enrolled as cases for the study and Healthy volunteers of the same age and gender-matched (n=75) were enrolled as the controls and subjected to the following inclusion and exclusion criteria. All cases and controls were assessed for their fibrinogen level at day 0 of the admission by using a Fibrinogen testing kit. The mean fibrinogen level of 357.5867 mg/dl (36.5218) in vasculopathy cases whereas 310.2800 mg/dl (27.6100) in controls with a statistically significant p-value by unpaired ‘t’ and Mann- Whitney statistics.62% Cases had Fibrinogen level above 350mg/dl in comparison only 10% controls had levels above 350mg/dl. On comparing fibrinogen individual vasculopathy, it was found that fibrinogen was a more significant risk factor in stroke >DVT> IHD
Utility of simple dipstick test in diagnosing urinary tract infection in children presenting with fever: A prospective observational study
Get PDFBackground: Urinary tract infection (UTI) in children continues to be under-diagnosed, despite its association with renal scarring, hypertension, renal failure, and other sequelae. To avoid these preventable complications, we should treat UTIs in children at the earliest. A simple, reliable, bedside test could solve this problem.
Methods: The study was conducted in a tertiary care hospital as a prospective observational study. The study included 534 children until 12 years of age (excluding neonates), presented with fever without focus or fever with urinary complaints. The Rapid diagnostic urine test was performed with a urine dipstick (Combur 10 test®), for urine nitrite, leukocyte esterase, and protein determination. Simultaneously urine culture was also sent. Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value, and diagnostic accuracy were calculated. Observations: Urine culture was found positive in 80 cases (14.9 %). When all the three tests were positive, diagnostic accuracy was maximum (90.7%). The diagnostic accuracy of the nitrite test was also > 90%. Furthermore, all three tests have very high negative predictive values (> 87%). Conclusion: If all three tests are positive or only nitrite is positive antibiotic should be started and given a full course of treatment irrespective of the urine culture report. All three tests have very high negative predictive values, which excludes UTI. The rapid diagnostic dipstick will reduce the workload of the laboratory. This may guide the clinician in managing OPD as well as inpatient empirical therapy, as delay or untreated UTI can have long-term future implications
Oral and Maxillofacial Myiasis: A Literature Review
Get PDFThe term “Myiasis†refers to the invasion of tissues and organs of animals and humans by the dipteran larvae. The infestation leads to gross destruction of vital tissues. Oro-maxillofacial myiasis is a rare and unique condition due to the abundance of vascularity of the region and the fact that the oral cavity is least conducive to the growth of larvae and completion of their lifecycle. The disease is more frequent in under-developed countries with hot humid climate. It is associated with debilitating medical conditions, poor oral hygiene, malignancy, alcoholism, suppurative lesions and mainly with unhygienic and poor living conditions. It can be diagnosed solely on clinical examination due to the presence of larvae. This article focuses on etiopathogenesis, clinical features and treatment modalities of oral and maxillofacial myiasis
Clinical profile and outcome of patients with diabetic foot infection: A single centre study
Get PDFIntroduction: Diabetes mellitus with its limb and life-threatening complication such as diabetic foot infection and amputation are increasing at epidemic rates all over the world.
Aim of the study: The study aims to find out the clinical profile and outcomes of patients with diabetic foot infections (DFI).
Methods: This was a prospective study conducted at a tertiary care institute. A total of 82 patients were included and analyzed in this study from January 2020 to December 2022. This study recruited patients >18 years of age, with DFI. All patients underwent a detailed history and clinical examination. Patients were classified as per the International Working Group on the Diabetic Foot -IDSA classification. The patients were followed up every month for 3 months. Clinical outcome was studied regarding the rate of amputations, readmissions, and mortality.
Result: A total of 82 patients were included and analyzed in this study. There are 36 (43.90%) patients from the age range 55-65 which is height and the lowest is 2(2.44%) patients from the age range 15-24. The ulcer healing during follow-up of the study, the mean±SD of the baseline is 14.85±23.12. After 1 month the percentage of wound healing is 20.88% and the mean±SD is 11.75±22.68, after 2 months the percentage of wound healing is 43.16% and the mean±SD is 8.44±22.05 and after 3 months the percentage of wound healing is 57.04% and the mean±SD is 6.38±21.19. The p-value of follow-up duration is equal to <0.001 which was shown as a significant change.
Conclusion: This study shows the predominance of monomicrobial growth and Gram-negative organisms in diabetic foot patients. With the increase in the severity of DFI, there was an increased rate of hospital readmissions, amputations (major and minor), and mortality. Dimensions of the ulcer may have a bearing on the rate of minor amputations
Effect of Momordica charantia (korola) in global cerebral ischemia-induced neuronal damage in rat brain
Get PDFBackground: Stroke is primarily a cardiovascular disease with a neurological outcome. Prophylactic neuroprotection might be a useful treatment approach with better outcome than current options. Momordica charantia (Korola) fruit juice has been shown different therapeutic effects including neuroprotection.
Objective: The objective of the study was performed to evaluate neuroprotective effect of Momordica charantia fruit juice in global cerebral ischemia induced neuronal damage in rats.
Methodology: Global cerebral ischemia was produced surgically by ligating bilateral and unilateral common carotid artery. Fresh raw juice of Momordica charantia (2-2.5 ml/rat/day) was given to experimental group starting one month before and continued up to two weeks after surgery. Forty wester Kyoto rats were recruited for experiment and divided into two groups. Neuroprotective role was measured with the Histopathological assessment of decapitated rat brain in terms of unaffected neuronal cell density and necrotic foci per high power field (HPF). The data analysis was done by unpaired t- test with the software SPSS version 17.0.
Results: Among 40 rats, 24 rats were alive until completion of experiment. The rats under experimental group who got Momordica charantia fruit juice had significantly more neuronal cell density (p=0.001) and less necrotic foci (p=0.001) compared with control group.
Conclusion: In this study, we found that Momordica charantia fruit juice has neuroprotective activity in global cerebral ischemia induced neuronal damage in rat brains. Since herbal drugs have been accepted widely in the recent years because of its’ relative higher therapeutic window, less serious side effects, and economical, Momordica charantia fruit juice might be the alternative of other synthetic neuroprotective agents in global cerebral ischemia-induced neuronal damage. However, in vivo study is warranted to establish this relation