Showing papers by "Khulna Medical College published in 2019"

Designing an Electro-Mechanical Ventilator Based on Double CAM Integration Mechanism

Abstract: This paper proposes a simplified structure of microcontroller based mechanical ventilator integrated with a Bag-Valve-Musk (BVM) ventilation mechanism. Here, an Ambu bag is operated with computer-aided manufacturing (CAM) arm that is commanded via a microcontroller and manual switches by sending a control signal to the mechanical system and according to this control signal, the mechanical computer-aided manufacturing (CAM) arm simultaneously compresses and decompresses the Ambu bag. It is a self-inflating bag and like a one-way valve around its inlet and outlet corner. By compressing the Ambu bag it delivers air and by relaxing, it takes air from the environment through a mechanical scavenger. The control signals are designed with three modes named adult mode, pediatric mode, and child mode based on the respiratory rate. The device is in assist controlled mode by dint of fixing the tidal volume for all unique control signals. The control signal is visualized by a platform known as the BIOPAC student’s lab system. The proposed device is portable, compact, low weight, and efficient performable. It can be supplied around the rural area hospitals for immediate medication with cost efficiency and risk avoidance. Anyone can operate it as no need to study or training of ventilation rules like ICU ventilator. The proposed system is safe, riskless, and repairable. The angle, volume, and respiratory measurement have found 95%, 92%, and 90% accuracy respectively. By applying this portable ventilator system immediate attention can be taken up in rural or general hospitals and in ambulances.

Association of p53 Gene Mutation With Helicobacter pylori Infection in Gastric Cancer Patients and Its Correlation With Clinicopathological and Environmental Factors.

Abstract: Background: Gastric cancer is also a leading cancer in Bangladesh like that of the global incidences. It is speculated that environmental, bacterial infection and molecular factors might have been carrying the key role of rising trend of the disease. This study was aimed to investigate the association of mutated p53 gene with of Helicobacter pylori ( H. pylori ) infection, clinicopathological and some environmental factors of the gastric cancer patients. Methods: This cross-sectional study was carried out from January 2015 to December 2016 in a specialized cancer hospital of Bangladesh. Patients were selected randomly who were admitted for surgical intervention after diagnosis as adenocarcinoma of the stomach and physically fit for surgery. After admission proper evaluation of the patients was done. Tissue sample from the gastrectomy specimen along with the blood sample was sent to the related laboratories. After DNA extraction for p53 , exons 5 and 6, they were adjusted for proper primer designing. Appropriate sequencing analysis of the result was done. Status of p53 was investigated to see their association with the result of the H. pylori , age and sex, tumor status, smoking and extra salt intake of the patients. Result of the study was calculated and analyzed by Chi-square and binomial logistic regression to find the association amongst them. Results: Among the 71 patients, mean age was 52.96 years old, male: female ratio were 48:23, age group above 41 years were 53 (74.6%), proliferative and ulceroproliferative group of the tumor dominated (87.3%). There were 52 cases with (73.2%) p53 mutation. Among the 51 H. pylori positive cases, 41 (80%) had p53 mutation (P = 0.033). Tumor size and lymph node status were found to be associated with the gene mutation (P = 0.05). Age also had strong correlation with the mutation (P = 0.015). Gene mutation was found mostly among the younger (<= 40 years) group of patients (94.4%). Patient with extra salt intake was also found related with the mutation (P = 0.03). Conclusions: Environmental and genetic factors seem to be risk factors for gastric cancer in Bangladesh. Nationwide anti H. pylori drive and further molecular research could elicit the other risk factors which might help to reduce the gastric cancer incidences in the country after taking appropriate measures. World J Oncol. 2019;10(1):46-54 doi: https://doi.org/10.14740/wjon1087

Demographic & Clinical characteristics with outcomes of snake bite in a tertiary hospital

Abstract: Background: One of the common medical emergencies is Snake-bite. Many patients die every year due to snakebite. However, the demographic feature, clinical manifestations, mortality and morbidity from snake-bite in our country has not been well studied. This study analyses demographic feature, clinical manifestations and outcomes of the snake bite poisoning in patients admitted to a medical college hospital. Aims & Objectives: To determine the demographic features, clinical manifestations and outcomes of the snake bite poisoning. Materials and Methods: This is an observational study done in the department of Medicine,Khulna Medical College Hospital from 1st July 2017 to 30th June 2018. Patients aged 13 years and above admitted with the suspicion of snake bite during the period were selected. Results: Out of 114 admitted snakebite patient most of the patients 50 (43.85%) are of younger age groups (13-40 years). Most bites occurred in rural area 108 (94.73%) and 74 (64.91%%) occurred between the months of July to September. Most cases 70 (61.40%) are non-venomous snake bites; krait was the main culprit for all venomous 44 (38.59%) cases showing neurotoxic features. Foot was the most common (42.10%) site of bite. ptosis (38.59%) and broken neck sign (17.54%) were the two most common clinical features. All venomous cases received 10-20 vials of anti-venom. 31.81% (14) of venomous patients developed respiratory failure requiring mechanical ventilation; of them 6 (13%) died. Conclusions: Snakebite is one of common emergency that endangers life in the study area. Treatment by Ohzas is very common and this causes Delay in hospitalization resulting in respiratory failure and increases mortality.