Showing papers by "Khulna Medical College published in 2012"

Prevalence of dental caries in the primary dentition among under five children

Abstract: Dental caries is the most important dental health problem in developing countries. The study aimed to estimate the prevalence of dental caries in primary dentition among under 5 years children. A simple random sampling method was used. Study population was under 5 children attending dental department of Khulna Medical College Hospital from January to June 2010. A total of 672 children were examined. The prevalence of dental caries was 44.34%. Caries prevalence was higher in the boys than the girls and it was statistically significant (P <0.05). It was also found that primary second molars were the highest carious tooth. The prevalence of dental caries among under 5 children was high. There is a need to generate awareness about oral health and the prevention of dental caries. DOI: http://dx.doi.org/10.3329/bmjk.v43i1-2.13015 Bang Med J (Khulna) 2010; 43: 7-9

Efficacy of a high-dose in addition to daily low-dose vitamin A in children suffering from severe acute malnutrition with other illnesses.

Abstract: Background Efficacy of high-dose vitamin A (VA) in children suffering from severe acute malnutrition (SAM) has recently been questioned. This study compared the efficacy of a single high-dose (200,000 IU) in addition to daily low-dose (5000 IU) VA in the management of children suffering from SAM with diarrhea and/or acute lower respiratory tract infection (ALRI). Methods In a randomized, double-blind, controlled clinical trial in icddr,b, Bangladesh during 2005–07, children aged 6–59 months with weight-for-height <−3 Z-score and/or bipedal edema (SAM) received either a high-dose VA or placebo on admission day. Both the groups received 5,000 IU/day VA in a multivitamins drop for 15 days and other standard treatment which is similar to WHO guidelines. Results A total 260 children (130 in each group) were enrolled. All had diarrhea, 54% had concomitant ALRI, 50% had edema, 48.5% were girl with a mean±SD age of 16±10 months. None had clinical signs of VA deficiency. Mean±SD baseline serum retinol was 13.15±9.28 µg/dl, retinol binding protein was 1.27±0.95 mg/dl, and pre-albumin was 7.97±3.96 mg/dl. Median (inter quartile range) of C-reactive protein was 7.8 (2.1, 22.2) mg/L. Children of the two groups did not differ in any baseline characteristic. Over the 15 days treatment period resolution of diarrhea, ALRI, edema, anthropometric changes, and biochemical indicators of VA were similar between the groups. The high-dose VA supplementation in children with SAM did not show any adverse event. Conclusions Efficacy of daily low-dose VA compared to an additional single high-dose was not observed to be better in the management of children suffering from SAM with other acute illnesses. A single high-dose VA may be given especially where the children with SAM may leave the hospital/treatment center early. Trial Registration ClinicalTrials.gov NCT00388921

Comparative Efficacy of Dried Fruits of Carica Papaya Linn. and Vitamin-E on Preventing Hepatotoxicity in Rats

Abstract: In the absence of an effective treatment in modern medicine, efforts are being made to find suitable herbal remedies for hepatitis. This prospective experimental study was conducted in the department of Pharmacology and Therapeutics, Dhaka Medical College, Dhaka from July 2006 to June 2007 to evaluate the hepatoprotective effects of Carica papaya against carbon tetrachloride (CCl 4 ) induced hepatotoxicity and compared it with that of vitamin-E. Total 36 adult rats were used and they were divided into six equal groups namely A, B, C, D, E and F. All the rats were fed with normal diet and 2ml distilled water orally for 7 days. In addition, Group D received Carica papaya extract, Group E received olive oil and Group F received vitamin E orally per day for 7 days. On the seventh day CCl 4 ) was administered to all the rats except Group A and was sacrificed on 8th day of experiment. Serum bilirubin, alanine amino transferase (ALT), aspartate amino transferase (AST), alkaline phosphatase and hepatic histopathology were done thereafter. Carica papaya and vitamin E showed significant hepatoprotection against CCL 4 ) induced hepatotoxicity but Carica papaya showed more significant changes in ALP level than vitamin E. Prevention of hepatic necrosis and fatty degeneration were also observed in Carica papaya and vitamin E pretreated rats but there is no significant difference. DOI: http://dx.doi.org/10.3329/fmcj.v7i1.10295 Faridpur Med. Coll. J. 2012;7(1): 29-32

Comparative Histological Study on the Spleen of Human (Homo sapiens), Cow (Bos indicus) and Goat (Capra hircus)

Abstract: Background: The spleen is the largest single mass of lymphoid tissue in all vertebrates. It is presumed that the architectural design of spleen of domestic and wild animal is different from man. Exact knowledge of histological structure of human, cow and goat can be helpful to differentiate among different species in vertebrates. Methods: A descriptive type of study was carried out in the department of Anatomy, Dhaka Medical College, Dhaka, from January to December 2008. Thirty human spleens were collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine of Dhaka Medical College, Dhaka. Spleens from cow and goat were collected from a slaughter house of Dhaka city. A total of 15 relatively fresh human samples, six from cows and six from goats were selected for histological study. Results: The mean thickness of the splenic capsule was 111.56±21.45 ?m in human, 196.88±11.91 ?m in cow and 251.44±12.56 ?m in goat. The difference in thickness of the splenic capsule was statistically significant among the human, cow and goat (p <0.001). However, no difference was found in diameter, number and percentage of the white pulp of the spleen among those species. Conclusion: There was statistically significant difference in the thickness of splenic capsule but no difference was found in the diameter, number and percentage of white pulp in the spleen of these species. DOI: http://dx.doi.org/10.3126/njms.v1i2.6601 Nepal Journal of Medical Sciences. 2012;1(2): 64-7

Dental management of COPD patient

Abstract: Chronic obstructive pulmonary diseases have increased in prevalence and the rate of death of this chronic inflammatory disease of the airways has also risen despite recent advances in medical treatments. The dental health care professionals must be prepared to treat more medically compromised individuals. Because dental professionals operate at the origin of the upper airway and many dental procedures are deemed stressful, patients with chronic respiratory diseases are at special risk. This article will review the patho-physiology and discuss the recognition and management of dental patients with these diseases and provide an understanding on how to avoid precipitating factors that could initiate an acute episode in the dental care setting. The most important factor in preventing COPD is helping patients stop smoking. DOI: http://dx.doi.org/10.3329/bmjk.v44i1-2.10472 Bang Med J (Khulna) 2011: 44(1&2) 21-24

Acute meningoencephalitis in hospitalised children in southern Bangladesh.

Abstract: Background: Acute meningoencephalitis is an important cause of morbidity and mortality around the globe. The objective of this study was to examine the distribution of acute meningoencephalitis and its aetiological agents among children admitted to a tertiary hospital in southern Bangladesh. Methods: This prospective study was carried out in Khulna Medical College Hospital from 2007 to 2009. All of the admitted children between 1 month and 12 years of age were enrolled over a 2-year period if they met the inclusion criteria of having an acute onset of fever (≤ 14 days) and any of the following 3 signs: neck stiffness, convulsion, or altered mental status. Cerebrospinal fluid (CSF) was collected within hours and sent to the laboratory for cytological and biochemical analyses. CSF was examined by Gram staining and a latex agglutination test to detect common bacteria. Serum and CSF were also tested for Japanese encephalitis virus antibodies. Results: A total of 140 children were included in the study, which accounted for 2.5% of admissions between 2007 and 2009. The number of acute meningoencephalitis cases was relatively higher (37.9%) during the monsoon season. The CSF report revealed a pyogenic form in 24 (18.5%) and a viral form in 13 (10.0%) cases. Altered mental status was significantly less frequent (P < 0.001) in cases of pyogenic meningoencephalitis (62.5%) than in cases of non-pyogenic meningoencephalitis (93.4%). Bacterial causes were identified in 11 (8.5%) children; the causative agents included Streptococcus pneumoniae (n = 8), Neisseria meningitides (n = 2), and Haemophilus influenzae (n = 1). Three (2.3%) patients were positive for Japanese encephalitis virus. Conclusion:S. pneumoniae was the most common bacteria causing acute meningoencephalitis among the study subjects, and Japanese encephalitis virus was present in few patients.

Study of adverse drug reactions in out-patient departments of a teaching hospital

Abstract: The study conducted in the Medicine and Skin outpatient departments of Dhaka Medical College, Dhaka revealed 19 cases (7 males, 12 females) of adverse drug reactions (ADR) out of 160 patients. 31.58% ADRs were of mild type, 42.1% were of moderate and 26.32% were of severe in nature. Gastrointestinal complications were the most frequent adverse effect (56%). Antimicrobial drugs were the most common cause of ADR (42.86%) followed by NSAIDs (33.33%). This study is a preliminary study for getting information on the pattern of ADRs in Bangladesh needing further studies.

Cervical ectopic pregnacy mimicking missed abortion

Abstract: Cervical pregnancy is a rare variety of Ectopic pregnancy. It is a life threatening form of ectopic pregnancy. The diagnosis of cervical pregnancy can be missed by an unsuspecting mind inspite of the routine use of first trimester Ultrasonography. Careful evaluation is necessary for immediate proper management of such case. DOI: http://dx.doi.org/10.3329/bmjk.v44i1-2.10474 Bang Med J (Khulna) 2011: 44(1&2) 28-30

Evaluation of Uterine Scar on Repeat Second Cesarean Section in Patients with Previous Cesarean Section

Abstract: To evaluate the safety and integrity of uterine scar at repeat cesarean section in patients with previous one cesarean section (C/S). A prospective study was Carried out in a tertiary care, obstetric unit over a period of one year, 2010. All pregnant mothers who underwent cesarean section either emergency or elective with history of previous one cesarean sections were included in this study. The variables noted were age, parity, socioeconomic status, residential area, location of previous cesarean section, previous wound infection and associated complaints. Data was analyzed on SPSS 11 Operative findings during cesarean sections were recorded in terms of thinning of scar, dehiscence or rupture. One hundred and twenty cesarean section patients were included in the study. Out of all patients, extreme thinning of scar was noted in 28 (23.33%) patients. Four patients (3.33%) had scar dehiscence,only 3( 2.5%) patients with scar dehiscence had associated complaint of scar tenderness, while 17 (14.16%) of 120 cases of scar thinning were having scar tenderness. All 4 cases of scar dehiscence had their previous c/s at peripheral hospitals. No patient underwent hysterectomy and all patients with scar dehiscence had successful repair. Our findings shows relatively inadequate scar thickness rate but at the same time relatively acceptable scar dehiscence rate. Thus it seems to be a safe approach to make trial of labour after meticulous scrutinization and individualization. DOI: http://dx.doi.org/10.3329/akmmcj.v3i1.10108 AKMMCJ 2012; 3(1): 16-19

Hepatic hydatid cyst presenting as cutaneous abscess.

Abstract: Hydatidosis is a parasitic zoonotic echinococcal infection that affects both humans and other mammals. These diseases are common worldwide but particularly common in sheep and cattle farming regions. Anaphylaxis mediated by IgE is a serious complication of surgery or trauma which necessitates more aware of its clinical features, diagnosis and management. It is important to make a preoperative diagnosis based on the typical image findings, so that particular precaution can be taken not to rupture the lesion. A woman presented with a right upper quadrant cutaneous abscess. USG reveals multiple cystic lesions in the liver arranged in cartwheel appearance, CT disclosed a cystic lesions having daughter cysts, marginal calcifications, marginal enhancement and contiguous abdominal wall abscess, which led to a diagnosis of complicated hepatic hydatid cysts with abdominal wall abscess formation. FNAC showed scolices surrounded by chronic inflammatory cells. Abdominal wall abscess may be a presentation of hydatid liver disease.

The Ten-Step Vaginal Hysterectomy A Newer and Better Approach

Abstract: Aims and Objectives: This study was undertaken to compare with the traditional Heaney‘s method of vaginal hysterectomy and the newer Ten-Step Vaginal Hysterectomy and to emphasize that this is a safe procedure with lesser blood loss, shorter operation time and shorter requirements of analgesia. Study Design: 110 Patients with non descent, first, second and third degree prolapsed uterus from 45 to 72 years of age were subjected to this study in Khalishpur Clinic. Those women were randomly selected. Among them 54 women had the traditional Heany‘s Methods of Vaginal Hysterectomy and 56 women had the Ten-Step Vaginal Hysterectomy (TSVH). The blood loss was measured by hemoglobin assessment before and 3 days after operation. Material and Methods: In Ten-Step Vaginal Hysterectomy the vaginal wall was incised by drop-like incision starting under the urethra, continuing laterally and down, encircling the cervix from behind and returning back to the starting point from the other side, then separation was done laterally to the side to the uterus. Bladder is detached from the uterus, and the posterior peritoneum is opened. The sacro-uterine ligaments and the paracervical ligaments are clamped together, cut and ligated in both sides. Next the uterine arteries are clamped, cut and ligated. Uterus is pulled down and two fingers are introduced behind the fundus to lift anterior peritoneum and opened under supervision. The round and ovarian ligaments and blood vessels are clamped together and ligated in both side. The peritoneum is left open, then reconstruction of the pelvic floor is done and the vaginal wall is closed continuously. Results: It was found that in comparison of traditional methods with the ten steps vaginal hysterectomy, there are lesser blood loss (400ml vs 80ml; P<0.05) with lower complications, shorter operation time (52.5min vs 30.3min; P<0.05), lesser pain and lesser requirements of analgesia (5.8 vs 3.9 days; P<0.05) and shorter period of convalescence. Hospital stay remains same for both groups. Conclusion: The Ten-Step Vaginal Hysterectomy is a better operation than traditional method of vaginal hysterectomy, Abdominal Hysterectomy and LAVH. At the same time this method is logical and easy to learn, to perform and to teach. DOI: http://dx.doi.org/10.3329/jbcps.v30i2.11407 J Bangladesh Coll Phys Surg 2012; 30: 71-77

Results of internal fixation and anterior muscle pedicle bone grafting in old femoral neck fracture

Abstract: Sixteen cases of old fracture neck femur were treated by internal fixation and anterior muscle pedicle bone grafting of rectus femoris, sartorius bone block from anterior superior iliac spine. The treatment period were from January 2000 to December 2009 at Khulna Medical College Hospital and some private hospital. Different methods of fixation and bone grafting procedure were reported. We did this procedure by open reduction and internal fixation by cannulated hip screws and muscle pedicle bone grafting. Additional cancellous bone grafting were done in every cases. Follow up period was 2 to 7 years (average 5 years). Evaluation parameter were union, non union. collapse of neck, avascular necrosis of femoral head (AVN) coxavara, shortening, pain, range of movement and functional activities and over all satisfaction of patient. The results of fracture healing rate was good (9), fair (4) and poor (3). The technique is simple, rewarding and easy access of fixation and muscle pedicle bone grafting. Bone graft was placed by making a gutter at fracture site and maintained by a screw or prolin suture. DOI: http://dx.doi.org/10.3329/bmjk.v43i1-2.13016 Bang Med J (Khulna) 2010; 43: 10-11

Computed tomographic evaluation of paediatric brain in a teaching hospital

Abstract: During the period of June ‘09 to June ‘11, a total 689 children under 15 year, underwent brain computed tomography in the department of Radiology & Imaging, KMCH. Trauma was the commonest chief complaint (38.6 %), followed by headache (27.3%), convulsion (11.5%), focal neurologic deficit (9.1%), fever (3.5%), developmental delay (2.9%), increasing head size (1.5%), and inability to straighten head (0.9%). Traumatic events (contusion, fracture, extra axial hematoma, intra axial hematoma) were commonest CT diagnoses (24.5%). The other diagnoses were generalized cortical atrophy (7.3%), infarction (4.9%), intracranial tumor (3.3 %), congenital lesions (3.3%), infective process (meningitis, abscess, empyema, encephalitis, tuberculoma, TORCH infection)-2.8%, hypoxic ischemic encephalopathy (2.6%), spontaneous intracranial hemorrhage (2.2%), white matter disease (0.6 %). Negative finding (45%) were also a frequent observation. Proper clinical assessment while advising pediatric brain computed tomography will reduce unnecessary CT scan and in some case initial imaging should be MRI. DOI: http://dx.doi.org/10.3329/bmjk.v44i1-2.10467 Bang Med J (Khulna) 2011: 44(1&2) 3-6

Burden and outcome of acute copper sulphate poisoning in a teaching hospital

Abstract: Copper sulphate poisoning is the most common poisoning next to organophosphorus poisoning with significant mortality. Gastrointestinal, liver, renal and haematological toxicities are common. A prospective observational study was conducted in department of medicine, KMCH, Khulna during the period of September, 2005 to March, 2007 to observe the presentation and outcome of copper sulphate poisoning. Forty patients with acute copper sulphate poisoning of different age group of both sexes were studied. Patients were evaluated through detailed history, clinical features, laboratory investigations and they were monitored closely at regular interval during hospital stay. Copper sulphate poisoning was found mostly in rural people (85%) and maximum (62.5%) patient were in the young age group of 16-25 yr. All patients had taken it as a suicidal attempt. Almost all patients presented with gastrointestinal symptoms-nausea (100%), vomiting (100%) and abdominal pain (90%). Subsequently hepatic toxicity was manifested by jaundice (32%), yellowish discoloration of urine (35%) which developed usually on the 2nd or 3rd day. Renal toxicities were manifested by oliguria (25%), haematuria (32.5%), albuminuria (30%) and renal dysfunction (30%). 35% of the patients were found to have anemia with Hb below 60%. Eight patients (20%) became unconscious at the terminal stage and died. DOI: http://dx.doi.org/10.3329/bmjk.v44i1-2.10468 Bang Med J (Khulna) 2011: 44(1&2) 7-10

Comparative Study between 12 and 15 Lead Electrocardiograms for Evaluation of Acute Posterior Myocardial Infarction

Abstract: Background: The ECG diagnosis of acute posterior infarction has traditionally been based on the presence of ST segment depression on the pericardial chest leads. However, such ST segment depression is neither specific nor sensitive for the diagnosis of a posterior infarction. Detection of ST segment elevation in V7- V9 in 15 lead ECG can help in early diagnosis of acute Posterior myocardial infarction. Method: Total of 100 patients Inferior myocardial infarction was evaluated by Electrocardiography in standard 12 lead and 15 lead. The patients were categorized into group I having posterior/ and or associated changes and group II having without posterior changes in ECG. Echocardiography and LVgraphy was done to evaluate the posterior wall movement. Result: For diagnosis of posterior myocardial infarction, 43.3% sensitivity and 95.1% specificity was found in 12 lead ECG, whereas in 15 lead ECG it was 80.0% sensitivity and 95.1% specificity. Conclusion: 15 Lead ECGs (including V7-V9) more sensitive than 12 lead ECGs in diagnosis of acute posterior myocardial infarction. Patient with inferior myocardial infarction or anterior ischemia developed more complications if associated with acute posterior myocardial infarction. 15 lead ECGs can routinely be used in patients with ischaemic type of chest pain. DOI: http://dx.doi.org/10.3329/cardio.v4i2.10460 Cardiovasc. j. 2012; 4(2): 153-163

Interventional radiology for the treatment of hepatic malignancy.

Abstract: Hepatic malignancies are commonly faced clinical problem. Non surgical minimally invasive therapies are current treatment goal. Interventional radiologists are going forwards with such minimally invasive but effective therapies by transarterial chemoembolization, radiofrequency ablation, percutaneous ethanol injection, cryoablation, laser ablation and upcoming promising procedures like focused ultrasound & gene therapy. Response rates of transarterial chemoembolization for primary and most metastatic tumors are 60-80% with survival rates of 70% at 1 year, 40% at 3 years, and 10% at 5 years. Percutaneous ethanol injection ablation is the most accepted minimally invasive method worldwide, for hepatocellular carcinomas less than 5 cm in diameter, the complete ablation rate is about 70-75%; in 5-8 cm diameter, encapsulated hepatocellular carcinomas, the rate is about 60%. RFA is becoming a widely used ablative technique for primary and secondary liver tumors, with a 52-67% complete ablation rate at 1 year and survival rates of 96%, 64%, and 40% at 1, 3 and 5 years, respectively. Meticulous patient selection, careful planning and execution are imperative and should be carried out with the participation of interventional and diagnostic radiologists, nuclear medicine specialists, and medical, surgical, and radiation oncologists. In terms of cost, equipment, technical efficiency, efficacy & repeated applicability percutaneous procedures particularly PEI & RFA can be carried out in Bangladesh.

Percutaneous ethanol injection for ablation of hepatocellular carcinoma

Abstract: Percutaneous ethanol injection (PEI) has been most widely performed as one of the effective ablative techniques for small Hepatocellular carcinoma (HCC). The ideal patient for alcohol injection should have fewer than three HCC tumors, each of which is well defined, less than 3cm in diameter, surrounded by a fibrous shell and not near the surface of the liver. It is contraindicated in patients with gross ascites, uncorrectable coagulopathy, obstructive jaundice and main portal vein thrombosis. This procedure is performed under ultrasound guidance in an outpatient basis with a 21-22 G needle & 95-100 % alcohol. Ethanol causes dehydration and subsequent necrosis of the HCC. Depending upon the tumor size, 2 - 12 ml ethanol per lesion is given, the numbers of session, generally, are once or twice per week for four to six sessions. Adverse effects are pain, fever, a feeling of alcohol intoxication and elevated transaminase. A major problem of PEI is tumor recurrence. Follow-up is done by imaging, tumor marker assay and selective use of fine-needle aspiration and biology. Several studies have shown similar or even better results with PEI than with surgical resection. PEI should be considered as first line treatment option for small HCC for its ease of execution, safety, low cost, repeatability & therapeutic efficacy. DOI: http://dx.doi.org/10.3329/bmjk.v43i1-2.13017 Bang Med J (Khulna) 2010; 43: 12-17

Socio-demographic determinants of upper gastrointestinal haemorrhage in a teaching hospital

Abstract: It was a prospective study carried out of all cases of haematemesis and or melaena at Rajshahi Medical College Hospital between December 2004 and March 2005 and determined demographic profile, clinical presentation, cause and outcome of upper gastrointestinal bleeding in a tertiary hospital of Bangladesh. Fifty adult patients presenting with haematemesis and or melaena admitted consecutively into medical units were evaluated through proper history taking, thorough clinical examination, endoscopic examination within 48 hours of first presentation and other related investigations. Patients who were not stabilized haemodynamically within 48 hours of resuscitation and endoscopy could not be done within that period were excluded from this study. Out of 50 patients 44 were male and 6 were female and average age of the patients was 39.9 years. Most of the patients belonged to low socio-economic condition- Farmers (22%), Service holder (18%), Laborers (l6%), Students (l4%), Businessman (8%), House wife (4%) and others (l8%). Farmers, service holders and laborers were the most affected group (57%). Among the patients monthly income (Tk) was > 20000/= (2%), 15000-20000/= (8%), 8000-15000 /= (10%) and 0-8000/= (80%). Haematemesis and melaena (42%), melaena (42%), Haematemesis (16%) were the presenting features. Endoscopy revealed that duodenal ulcer (34%) was the most common cause of upper gastrointestinal (GI) bleeding followed by rupture of portal varices (16%), neoplasm (10%), gastric ulcer (08%) and gastric erosion ( 06%). Peptic ulcer disease still remains as the major cause of upper (GI) haemorrhage though cases of ruptured oesophageal varices are gradually increasing. DOI: http://dx.doi.org/10.3329/bmjk.v43i1-2.13014 Bang Med J (Khulna) 2010; 43: 3-6

Magnitude of cancer patients in a teaching hospital

Abstract: This was an observational study carried out among all cancer patients attended at radiotherapy department of Khulna medical college hospital between January 2010 and December 2010. The study aimed to develop a primary data source for further research and improvement of patient care. Data were collected by a questionnaire. Total study population was 321 and out of them 158 was male and 163 were female. Top five organs involved with malignancies of both sexes are breast (14.64%), non-Hodgkin’s Lymphoma (1 0.59%), lung (7.79%), mouth and oral cavity (7.48%), and stomach (7.48%). This hospital-based cancer registry should be maintained to improve the treatment facilities and follow-up system. DOI: http://dx.doi.org/10.3329/bmjk.v44i1-2.10471 Bang Med J (Khulna) 2011: 44(1&2) 18-24

Histomorphometric study of the human spleen

Abstract: Context: The spleen is the largest single mass of lymphoid tissue in all vertebrates. Histological changes are evident in advancing age along with functional capability of the human spleen. A cross-sectional, descriptive type of study was done in the Department of Anatomy, Dhaka Medical College, Dhaka, from January to December 2008, to see the age related microscopic changes in the human spleen. Methods: 30 human spleens were collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine of Dhaka Medical College, Dhaka. The samples were divided into three age-groups including group A (15-29 years), group B (30-49 years) & group C (50-69 years). Then 5 best prepared histological slides from each group were taken and examined under the light compound microscope to determine the thickness of capsule, diameter, number and percent amount of white pulp in the human spleen. Results: The thickness of the splenic capsule were found 84.60±7.97 ?m, 117.92±4.16 ?m, and 132.17±6.37 ?m in group A, B and C respectively. The diameter of the white pulp were found 0.32±0.01 mm, 0.32±0.01 mm and 0.31±0.01 mm, while the number of white pulp per sq. mm were 2.28±1.04, 2.38±0.93 and 2.04±0.76 in group A, B and C respectively. Moreover, the amounts of the white pulp were determined 23.09±1.38, 24.45±1.84 and 22.54±1.08 in group A, B and C respectively. The difference in thickness of the splenic capsule was statistically significant among the study groups (p<0.001). However, no difference was found in diameter, number and percentage of the white pulp of the spleen among those age groups. Conclusion: The thickness of the capsule of the spleen was found to increase with advancing age in humans. However, no age change was evident in diameter, number or amount of the white pulp. DOI: http://dx.doi.org/10.3329/bjms.v11i4.12600 Bangladesh Journal of Medical Science Vol. 11 No. 04 Oct’12

Is There any Association Between CagA+ H. Pylori Infection and Histopathological Types of Gastric Carcinoma

Abstract: Enormous studies have been conducted worldwide regarding CagA+ status of H. pylori in gastric carcinoma. But no study relating CagA+ status and gastric carcinoma has been carried out in our country yet. Thus, this study has been designed to see the association between CagA+ H. Pylori infection and histopathological types of gastric carcinoma. For this purpose, a total number of 80 (eighty) patients were selected. Of the 80 (eighty) patients 40 (forty) were selected as cases (malignant) and the remainder 40 (forty) were selected as controls (non-malignant). H. pylori was detected by applying non-invasive (H. pylori IgG serology and CagA IgG serology) and invasive (Histology and rapid urease test) technique. Of them Histology was done by Modified giemsa stain which was regarded as gold standard, CagA IgG was detected by ELISA method. Study reveals that there is no significant difference between histologic sub-types (Intestinal vs. Diffuse) of gastric carcinoma in relation with H. pylori positivity and present study also shows that there is no significant difference among the sites of lesion regarding H. pylori positivity. In this study, we see that among the 40 cases, 35(thirty five) possess the CagA+ H. pylori strain. And among the 40 controls, 33(thirty three) bear the CagA+ H. pylori strain. Here case-control difference is insignificant regarding CagA IgG status.The present study supports the view of an association of H. pylori infection with both intestinal and diffuse types of gastric cancer. It may be possible that H. pylori may be causally related to both forms of gastriccancer via unknown mechanism or this finding may be due to small sample size. In this study, no significant difference between case and control on the point of CagA IgG status was found. There are sufficient papers in favor of it-which argues that CagA positivity as well as H. pylori positivity is not the sole causative agent of gastric carcinoma. If so,it merely acts as an initiator.However,it is being left open for the future researchers to prove or to disprove it. Medicine Today 2010 Volume 22 Number 02 Page 62-69 DOI: http://dx.doi.org/10.3329/medtoday.v22i2.12435

Syringomyelia with atypical presentation

Abstract: A 50 years old male patient was admitted in Khulna Medical College Hospital with grade-III weakness of both upper limbs and grade-IV weakness of both lower limbs, marked wasting of muscles in upper back and shoulder girdle region. There was no fasciculation, no pyramidal signs and no sensory loss. All routine investigations including NCS and EMG were normal. MRI of cervical and dorsal spine revealed a large syrinx extending from the cervico-medullary junction to the sixth dorsal spine with herniation of cerebellar tonsil through foramen magnum. With these findings the case was diagnosed as syringomyelia with atypical presentation. DOI: http://dx.doi.org/10.3329/bmjk.v43i1-2.13019 Bang Med J (Khulna) 2010; 43: 21-22

Leprosy - An Overview

Abstract: Medicine Today 2011 Volume 23 Number 01 Page 44-50 DOI: http://dx.doi.org/10.3329/medtoday.v23i1.11946

Ovarian Mucinous Cystadenoma Presenting as Pseudo-Meigs Syndrome

Abstract: Meigs syndrome is defined as the co-existence of benign ovarian tumor with ascites and hydrothorax that resolves after resection of tumor. The ovarian tumor in Meigs syndrome is fibroma. On the contrary, Pseudo- Meigs syndrome is characterized by the co-existence of hydrothorax, ascites and ovarian tumor either benign or malignant other than ovarian fibroma. The case herein concerns a 70 year old postmenopausal woman presented with the complaints of progressive shortness of breath on exertion and progressive swelling of lower abdomen. Her clinical and radiological examination revealed a massive right sided pleural effusion, mild ascites and a large heterogeneous pelvic mass with solid and cystic components, suggestive of left ovarian tumor. The patient underwent an exploratory laparotomy with excision of tumor, right ovary and whole of the uterus. The tumor was diagnosed histologically as an ovarian mucinous ystadenoma. Postoperative resolution of hydrothorax and ascites confirmed the diagnosis of Pseudo-Meigs syndrome. DOI: http://dx.doi.org/10.3329/jom.v13i2.12760 J Medicine 2012; 13 : 216-218

Gangrenous jejunogastric intussuception as a complication of gastric surgery

Abstract: Jejunogastric intussusception (JGI) is a rare but serious complication following gastrojenjunostomy operation. Clinical presentation may be acute or chronic. The efferent loop intussusception is most frequent type. Our case report include a 60 years male presented with sudden onset of epigastric pain, vomiting, hematemesis and a palpable mass at epigastrium with previous history of gastric surgery about 11 years back. Diagnosis of JGI was confirmed with endoscopy findings. After prompt resuscitation early surgery was done. Gangrenous segment was resected and revision surgery was done in Roux-en-Y pattern. Post-operative period was uneventful. Awareness of such complication, early diagnosis and prompt surgery can reduce the mortality of JGI. DOI: http://dx.doi.org/10.3329/bmjk.v43i1-2.13018 Bang Med J (Khulna) 2010; 43: 18-20

Intradural Extramedullary Vascular Schwannoma at Upper Dorsal Level—A Case Report

Abstract: A young male patient of 24 years was presented with the complaints of upper back pain, hyposthesia and unable to walk. MRI of upper dorsal region reveals intradural extramedullary mass lesion extending from D1 to D4 with moderate enhancement of gadolinium. Hence an extensive laminectomy and total removal of the mass. Peroperative impression and histopathological findings confirm vascular schwannoma. After operation dramatic improvement of signs and symptoms, patient can walk with minimum support during discharge from hospital. Medicine Today 2010 Volume 22 Number 02 Page 103-105 DOI: http://dx.doi.org/10.3329/medtoday.v22i2.12445

Maternal complications of menstrual regulation

Abstract: This prospective observational study was done in Obstetrics and Gynecology unit in Kalaroa Health Complex, Kalaroa & Sadar Hospital, Satkhira from 1st January 2009 to 30th June 2010. The aim of it was to evaluate complications due to menstrual regulation (MR) risk factors for complications, immediate morbidities and mortality & management pattern. Total number of admission was 773, out of which only MR complications was 6.46%. Within this group, 96% patients belonged to 20 to 40 years age group, 84% were multipara. Gestational age in between 7 to 9 weeks was recorded in 72% and in 50% cases, MR was performed in private chamber, 12% patients was suffering from only pervaginal bleeding with nonfatal complications. Shock and acute abdomen due to visceral injury was 26% in which abdominal surgery was done in 12% cases. 94% patients improved after comprehensive management. Death was recorded in 6% cases. MR complications still remain an important cause of maternal morbidities and mortality in Bangladesh. DOI: http://dx.doi.org/10.3329/bmjk.v44i1-2.10469 Bang Med J (Khulna) 2011: 44(1&2) 11-14