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.

Institutional and population based analyses on misdiagnosis of appendicitis in Khulna, Bangladesh

Abstract: The aim of the present study was to identify factors associated with misdiagnosis of appendicitis to propose solutions to decrease the misdiagnosis rate of appendicitis. The study conducted an institutional and a population based analyses on misdiagnosis of appendicitis conducted in Khulna district, Bangladesh. The study dealt with 2 groups of patients. Group 1 consisted of the patients treated in Gazi Medical College Hospital (GMCH), Khulna either in out-patient department (OPD) within the last 3 years (from 2014 to 2016), treating doctors suggested appendicectomy and in indoor-patient department (IPD) within the last 5 years (from 2012 to 2016), the diagnosis was done either during operation or admitted as postoperative complications. Patients for Group 2 were selected purposively from the patients who were from different villages of Rupsha and Fakirhat Upazila or from Khulna city previously underwent appendicectomy within the last 5 years (from 2012 to 2016) in different hospitals other than GMCH, Khulna and previous symptoms were still existed. The study revealed that the majority of the patients were female (OPD 81.5%, IPD 68.8% in Group 1 and 83.2% in Group 2). The misdiagnosis rate of appendicitis for the patients attended GMCH OPD and GMCH IPD was 23.0% and 8.9%, respectfully. The overall misdiagnosis rate of appendicitis for the patients attended GMCH was 14.0%. In case of the patients attended GMCH OPD, most of them had UTI and chronic cystitis (45.5%). In case of the patients attended GMCH IPD, most of them had non-inflamed appendix (84.4%). The misdiagnosis rate of appendicitis for the patients in Group 2 was 23.2%. Some factors were identified and bearing in mind the factors, all the concerned should be more careful and conscious while making the diagnosis of appendicitis to avoid misdiagnosis and patients’ suffering. Mediscope Vol. 4, No. 2: Jul 2017, Page 29-34

Efficacy of low dose hyperbaric bupivacaine in spinal anaesthesia for LUCS

Abstract: Spinal Anaesthesia (SAB) is a popular anaesthetic technique in LUCS. SAB is performed in sitting and lateral position. The aim of this study is to explore the efficacy of spinal anaesthesia ie, height of block and haemodynamic changes with low dose hyperbaric bupivacaine in different position in LUCS. Total 80 of ASA grade I & II elective LUCS patient preloaded with 800-1000 ml of isotonic fluid were allocated randomly to receive different doses (10 mg, 12 mg,) of 5% Hyperbaric bupivacaine at L4-L5 interspaces in sitting (S group) and in lateral (L group) position to compare the height of block and haemodynamic changes. In sitting position in 10 mg dose group (S 10) adequate block developed in 7 patients out of 20 (35%) with no fall of systolic BP, in 12 mg dose group (S12) adequate block developed in 14 patients out of 20 (70%) with fall of systolic BP>1/3rd in 2 patients (10%). In lateral position groups (L group) with 10 mg dose ((L 10 group), 17 patients out of 20 got adequate block (85%) with fall of systolic BP>1/3rd in 2 patients out of 20 (10%) and in 12 mg dose group (L 12) adequate block in 20 patients out of 20 (100%) with fall of systolic BP>1/3rd in 5 patients out of 20 (25%). So block height with low dose of Hyperbaric Bupivacaine for caesarean section is more predictable and haemodynamically stable in lateral position DOI: http://dx.doi.org/10.3329/bmjk.v45i1-2.13624 Bang Med J (Khulna) 2012; 45 : 15-18

Complications of chronic arsenic poisoning

Abstract: Many highly toxic weedkillers and insecticides containing organic and inorganic chemicals have been developed in recent years 1,2. They are being used indiscriminately in developing countries to increase crop production from limited land resources. Insecticides, plus the unsafe disposal of many industrial waste products are believed to have raised the lead, arsenic, cadmium, mercury and cyanide content of underground water. These are potential causes of chronic poisoning if drinking water contains a high concentration of these elements. Recently, sporadic cases of chronic arsenic poisoning were encountered in the northern part of Bangladesh and adjacent West Bengal, India. Concerned authorities in both countries have sealed many shallow tube wells owing to increased arsenic content of the water 3,4. Our involvement with II cases of chronic arsenic poisoning (CAP) with serious complications led us to compile this report.

Pseudomyxoma peritonei: A Review

Abstract: Pseudomyxoma peritonei (PMP) is rare clinical entity characterized by abundant extracellular mucinous material in the peritoneal cavity and tumoural implants on the peritoneal surfaces. The origin of PMP is controversial. It often arises from the goblet cells of large bowel or appendix. There is increase in MUC-2 secreting cells and accumulation of excessive mucin secreted by these cells in the peritoneal cavity. A ruptured appendiceal mucinous adenoma is the most common origin. Low grade ovarian malignancy is often associated. Patient may present with growing abdominal masses associated with abdominal pain, nausea, vomiting, fatigue and weight loss. Ultrasonogram and CT scan of the abdomen have role in diagnosis but diagnosis is often difficult before laparotomy or laparoscopy. Debulking surgery with intraperitoneal hyperthermic chemotherapy is the treatment. DOI: http://dx.doi.org/10.3329/fmcj.v7i2.13523 Faridpur Med. Coll. J. 2012;7(2):88-92

Procalcitonin – A Reliable Marker for Diagnosis of Neonatal Sepsis in Compare to CRP

Abstract: Background: Early recognition and diagnosis of neonatal sepsis are difficult because of the variable and non-specific clinical presentation of this condition. It is extremely important to make an early diagnosis of neonatal sepsis for prompt institution of antimicrobial therapy. So the objective of the study was to evaluate the efficacy of serum procalcitonin as a reliable marker in diagnosis of neonatal sepsis. Methodology: This cross sectional analytical study was carried out in the Special Care Baby Unit of a tertiary level care hospital in Bangladesh from September 2012 to May 2013. Total 75 newborn with suspected sepsis were included in the study. Specimens of blood were obtained from each neonate prior to commencement of antibiotic for sepsis work up. Serum CRP and procalcitoninlevels were measured. The data from blood cultures were used as the gold standard to evaluate the optimum sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the Receiver Operative Characteristic (ROC) curves. Results: Among total 75 newborns included in this study, 49.3% (37) newborn were diagnosed as proven sepsis and 50.7% (38) newborn as clinical sepsis.The procalcitonin (PCT) was high in 58.7% (500- 500pg/ml, the sensitivity of PCT in detecting sepsis was 48.6%, its specificity 76.3%, positive predictive value was 66.7%, and negative predictive value was 60.4% whereas the sensitivity of CRP for predicting sepsis was 35.1%, specificity 78.9%, positive predictive value 61.9% and negative predictive value was 55.6%. The area under the ROC curve for procalcitonin(0.653) was significantly higher than CRP (0.571). Conclusion: Serum PCT was superior to serum CRP level in terms of early diagnosis of neonatal sepsis, in detecting the severity of sepsis. PCT is a reliable marker than CRP in the diagnosis of neonatal sepsis. Bangladesh J Child Health 2018; VOL 42 (1) :19-25