Khulna Medical College

About: Khulna Medical College is a healthcare organization based out in Khulna, Bangladesh. It is known for research contribution in the topics: Hysterectomy & Cancer. The organization has 266 authors who have published 203 publications receiving 964 citations. The organization is also known as: Khulna Medical College, Khulna & KMC.

Safety of routine caesarean myomectomy

Abstract: The study was done to evaluate the safety and clinical outcome of routine caesarean myomectomy. This was a prospective descriptive study done in Obstetrics & Gynaecology department of Khulna Medical College Hospital & Sadar Hospital, Satkhira and two private clinics in Khulna city. Over a period of 4 years from July, 2009 to June, 2013, twenty one cases of caesarean myomectomy were presented. Our technique comprised of infiltration of vasoconstritive agent (ceprecin) before nucleation of myoma, myoma cavity accomplished by using "U" stitches of myometrial closure, routine use of oxytocin in post operative period for 24 hours. It was seen in this study that the mean age of the patients was 31.7 years and most of the cases (71.43%) were primigravida. Caesarean myomectomy done in term pregnancy was 85.71%. Elective surgery was done in 85.71% and emergency surgery was 14.29%. Two leading indications for caesarean section were malpresentation/ abnormal lie in 42.85% and uterine fibroid in 23.81%. Fibroid in lower uterine segment for selective myomectomy was 61.90%. Maximum (21,65.63%) fibroids were removed from the lower uterine segment and 22 (68.75%) of the fibroids were between 5 cms to 10 cms in size. The morbidities encountered were anaemia with blood transfusion in 2 (9.52%) and post partum pyrexia in 1 (4.76%) patients. No woman needed hysterectomy. Caesarean myomectomy may be done routinely by experienced surgeon and routine use of vasopressin into myoma capsule to combat uterine atony & severe bleeding. DOI: http://dx.doi.org/10.3329/bmjk.v46i1-2.18232 Bang Med J (Khulna) 2013; 46 : 7-11

Outcome and prognostic factors of acute meningoencephalitis in children of Southern Bangladesh

Abstract: Objective: To estimate the outcome of acute meningoencephalitis (AME) in children and evaluate the impact of prognostic factors. Design and setting: A prospective cross sectional study was conducted in the paediatric ward of Khulna Medical College Hospital from 2007- 2009. Method: All admitted children, aged 1 month to 12 years, satisfying the case definition were enrolled into the study. Cerebrospinal fluid (CSF) was collected for cytology and biochemistry to categorize AME into pyogenic, viral or normal varieties. CSF was tested for common bacterial antigen and, along with serum was also tested for Japanese encephalitis virus antibodies. Patients were monitored twice daily until the final outcome. Results: One hundred and forty children were inducted constituting 2.5% of admissions. Infants (30%) were the worst sufferers. Twenty one (15%) children with AME died which is 4 times higher than the overall mortality (3.8%) in paediatric ward (p S Pneumoniae . Low GCS score was associated with higher mortality (p Conclusions: Mortality from AME was 15%. Low GCS score was associated with higher fatality. (Key Words: Outcome; prognostic factors; meningoencephalitis; Bangladesh) DOI: http://dx.doi.org/10.4038/sljch.v42i1.5291

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

Laurence Moon Bardet Biedle Syndrome

Abstract: Laurence Moon Bardet Biedle syndrome is a rare, autosomal recessive genetic disorder involving multiple systems and has wide spectrum of clinical features. Characteristic features of this disorder are retinitis pigmentosa, polydactyly, truncal obesity and learning difficulties. It may also be associated with hypogonadism in male and complex genitourinary abnormalities in female. We present a case of 33 years male patient having obesity, decreased vision, polydactyly, hypogonadism and retinitis pigmentosa. These clinical features are consistent with Laurence Moon Bardet Biedle syndrome. Medicine Today 2018 Vol.30(1): 41-43

Indication and outcome of relaparotomy after caesarean section

Abstract: The objective was to determine the indicatons, management and the outcome among the patient who underwent relaparotomy after caesarean section and to suggest the way to improve the quality of care. This was a retrospective descriptive study done in a tertiary level referral and teaching hospital, Khulna, Bangladesh, out of 55 cases requiring relaparotomy after caesarean section. Over a period of 15 months from 1st January 2011 to 31st march 2012, 1180 caesarean deliveries were done, out of total 3270 deliveries. During this period, relaparotomy was done in 55 cases. Among these, 10 cases followed caesarean delivery at this institute itself, while 45 cases have had caesarean delivery at peripheral hospitals. Postpartum haemorrhage in 31 cases (56.36%) and rectus sheath haematoma in 8 cases (14.55%) were the leading cause of relaparotomy. Among the 55 cases, 39 had emergency caesarean delivery while 16 had elective operation. Procedures undertaken at laparotomy were hysterectomy in 21 cases (38.18%), resuturing of uterine wound with uterine brace suture in 13 cases(23.63%), bilateral uterine arteries and ovarian vessels ligation in 7 cases (12.73%), drainage of haematoma in 8 cases (14.55%), and repair of anterior abdominal wall & peritoneal toileting in 5 cases (9.09%). A third laparotomy was done in 3 cases of which 2 cases were due to secondary PPH, a negative relaparotomy was done in one case. There were 7 maternal deaths following relaparotomy caused by hemorrhagic shock, septicaemia & renal failure and was 12.73%. Caesarean section is a life saving operation. However maternal mortality and near miss fatality after relaparotomy following caesarean section are common. So, relaparotomy should be considered as a procedure after a near miss fatality of mother. DOI: http://dx.doi.org/10.3329/bmjk.v45i1-2.13625 Bang Med J (Khulna) 2012; 45 : 19-23