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: Pregnancy & Hysterectomy. The organization has 266 authors who have published 203 publications receiving 964 citations. The organization is also known as: Khulna Medical College, Khulna & KMC.

Evaluation of Use Pattern of Analgesics in Post-Operative Pain Management among Surgically Treated Patients in a Tertiary Hospital in Khulna, Bangladesh

Abstract: Background: Effective management of postoperative pain provides a significant successful outcome of any surgical cases. Objectives: This study was designed to address the evaluation of using analgesics in relieving postoperative pain. Methods: After taking proper approval from hospital administration a prospective observational study was conducted in 250 surgically treated patients from January 2019 to May 2019 in a tertiary care hospital where patient of all ages and both sexes were included and prescriptions which did not contain analgesics were excluded from the study. Data was collected from day of operation to 5th post- operative day (POD) of each individual patient. Analysis of data was done by SPSS of 18.0 version. Results: Among 250 patients recruited 165 (66%) patients were female and highest numbers of patients were in the age group 18- 37 years 180 (72%). In the day of operation opioid tramadol and non-opioid diclofenac was mostly prescribed analgesic. Associated analgesicswere pethidine and or ketorolac. Among different combinations of analgesics, ketorolac & diclofenac combination 33% is used in highest cases. Average number of analgesic was 2.1 in the day of operation which became 1 in 5th POD. Percentage of patients prescribed analgesics from national essential drug list was 22%. The most common route of administration was intravenous (91.6%). Oral form was prescribed in 4th & 5th postoperative day. Conclusion: These results emphasize that a further study is needed to improve analgesic use by following standard treatment guideline to achieve effective pain management.

Outcome of Bridge Technique with Fibular Graft in Patients with Distal Tibial Non-Union

Abstract: Background: Non-union is an inevitable consequence in many circumstances of compound distal tiabial fracture. In many recent research papers, now-a-days, it has been claimed that bridge graft with fibula is good treatment option for management of such cases of non-union in clinical situations with distal tibial fracture. Methodology: This prospective study was conducted with a toal number of 12 patients with non-infected distal tibial non-union were treated with fibular graft technique from October, 2014 toSeptember 2020 in Khulna Medical College Hospital and in private hospitals. To select sample, convenient purposive sampling was used. Results: Among the study population, 58.3% (07) patients were male. 33.3% (04) of male patients were in 30-40 years age group, whereas in female patients, majority of the patients (25%) were in 40-50 years age group. Road traffic accident was found as the commonest mode of injury in 50% (06) patients of distal tibial fracture. Gustilo-Anderson grade IIIA was the mostcommon type (58.3%). Excellent outcome was observer in 75% (09) patients. In 58.3% (07) patient, there was no chronic pain in follow-up. However, chronic pain at donor site was found in approximately 33.3% (04) patients. Only in 1 patient (8.3%) persistent chronic pain was observed donor site. Healing occurred fairly by primary intention in 83.3% (10) patients, whereas in 16.7% (02) patients, healing occurred by secondary intention. Overall in 75% (09) patients, no obvious complication was observed. Refractory complication was observed in only 1 patient (8.3%). Conclusion: Bridge graft with fibula for managing distal tibial non-union isaresilient treatment option with fewer and manageable complications.

Impact of Momordica Charantia (Karela) on the Fasting Blood Glucose level in the Streptozotocin-Induced Diabetic Rats

Abstract: Context: Scientific studies revealed the hypoglycaemic properties of momordica charantia. The present study was carried out to find out microscopically whether Momordica charantia (karela) has got any impact lowering of FBG (Fasting Blood Glucose) level in diabetes mellitus. Study type: an experiemental study. Setting: Anatomy department of the then IPGMR (Institute of Post Graduate Medicine and Research) at present BSMMU (Bangabandhu Sheikh Mujib Medical University) and BIRDEM (Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine & Metabolic Disorders). Subjects: Sixty five healthy young Long Evans rats of male sex weighing 150 to 280gm aged between 10 to 12 weeks were used in this study. Methods: The rats were divided into four equal groups depending on their different sorts of dietry feeding and drug treatment. Main outcome measures: variation of differential FBG level in different groups of rat. Result: Mean 'initial' and 'final' (on day 7 and day 51 from Streptozotocin/vehicle injection) fasting blood glucose (FBG) level in the control group (Group-A) was 7.872 ± 0.60 and 8.55 ± 0.82 respectively. Therefore the mean (FBG) increased by about 13% (P = 0.022*) which is higher than that of the initial value. In untreated diabetic group the mean initial (FBG) level was 25.95 ± 8.90 and the mean final was 24.02 ± 4.08. So here, the (FBG) level decreased by about 13% (P = 0.557). On the other hand, in the insulintreated diabetic rats the mean initial (FBG) level was 24.35 ± 6.81 and the mean final was 8.38 ± 5.02, which is lower (P = 0.000*) & in the karela–treated diabetic rats, the initial (FBG) level was 23.03 ± 5.70 and the mean final was 5.65 ± 1.29 which is lower* (P = 0.000*). The value in the insulin-treated diabetic rats & in the karela-treated diabetic rats were significantly lower than that of the untreated diabetic rats (P = 0.007) & (P= 0.005) respectively. But there was no significant difference between the insulin-treated diabetic rats & the karela-treated diabetic rats (P = 0.605) in this regard. Conclusion: Karela showed a tendency of acting against hyperglycemic effects of Streptozotocin-induced diabetes mellitus. However, further investigations are recommended for establishing karela as a safe, useful effective anti- hyperglycemic agent as well as antidiabetogenic agent. Key words: Diabetes mellitus; Hyperglycemia; Momordica charantia (karela) DOI: http://dx.doi.org/ 10.3329/bja.v9i1.8148 Bangladesh Journal of Anatomy January 2011, Vol. 9 No. 1 pp 45-48

Prevention of Intra-Operative Cerebrospinal Fluid Leaks by Lumbar Cerebrospinal Fluid Drainage during Endoscopic Endonasal Trans- Sphenoidal Surgery for Pituitary Macroadenomas

Abstract: Aim and Objective: Postoperative cerebrospinal fluid leak is a recognized complication of endoscopic endonasal trans- sphenoidal surgery for pituitary macroadenomas. In this study we assess the utility of prophylactic use of lumbar drain in preventing intra-operative cerebrospinal fluid leakage during endscopic endonasal transsphenoidal surgery for pituitary macroadenoma which will ultimately reduce the rate of persistent post-operative cerebrospinal fluid leakage. Materials and Methods: 34 patients who underwent endscopic endonasal transsphenoidal surgery for pituitary macroadenoma were dividedd into two groups by non-probability convenient sampling technique. In one group of which lumbar subarachnoid drain were given just before induction of anesthesia named LD Group and another group went through conventional method without giving lumbar drain named No LD Group. In all patients of LD Group 20-30 ml of CSF was drawn through lumbar drain before giving dural incision. Valsalva maneuver was used in each group to identify intraoperative CSF leaks at the end of definitive surgery before repairing the sellar floor.Zero degree rigid endoscope was used in all cases. Intraoperative CSF leak was categorized as ‘Yes’ or ‘No’ which was decided by surgeon.Lumbar drains were removed within 24 hours of operation in 16 patients of LD Group and in case 1,who developed intraoperative CSF leak, lumbar drain was removed later. Results: Thirty four patients were eligible for inclusion, of which 17 were assigned to the LD Group and 17 to the no LD Group. There were no statistically significant differences in patient demographics, tumor pathology, or radiology between the two groups. In LD Group intraoperative CSF leak occurred in 1(5.9%) patient and leak did not occur in 16(94.1%) patients, in No LD Group intraoperative CSF leak occurred in 14(82.4%) patients and leak did not occur in 3(17.6%) patients. Intraoperative CSF drainage significantly reduced the incidence of intraoperative CSF leaks from 82.4% in the No LD group to 5.9% in the LD group (P < 0.001). There were no catheter related complications. Conclusion: Intraoperative CSF drainage significantly reduces the incidence of intraoperative CSF leakage in patients undergoing endoscopic endonasal transsphenoidal surgery for pituitary macroadenomas. Bang. J Neurosurgery 2020; 10(1): 52-56

Ewing's sarcoma of rib

Abstract: Ewing's sarcoma is an uncommon malignant bone tumour occuring in children, adolescents and young adults. We report a case of a 13 year old male admitted to Khulna Medical College Hospital with history of pain and swelling in chest wall for two weeks. Earlier chest X-ray showed a mass lesion in the left upper part of chest wall and erosion of first rib. Subsequent X-ray revealed left sided massive pleural effusion. CT scan revealed a mass lesion in the left upper part of chest wall originated from left first rib and left sided pleural effusion. FNAC from the mass lesion revealed features suggestive of Ewing's sarcoma. Patient was treated with chemotherapy and after first cycle there was significant improvement of all the signs and symptoms. Bang Med J (Khulna) 2017; 50 : 41-43