Background: Detection of aneurysms among spontaneous subarachnoid haemorrhagic patients is a crucial issue for management. Objectives: The purpose of the present study was to compare the findings of 3D-computed tomographic angiography with digital subtraction angiography for detection of aneurysms among spontaneous subarachnoid haemorrhagic patients. Methodology: This comparative cross-sectional study was carried out in the Department of Neurosurgery and Cath Lab of Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh in collaboration with private diagnostic centre from September 2013 to February 2015 for a period of six (06) months. Adult patients diagnosed as a case of spontaneous SAH based on clinical features and confirmed by plain CT evidence of subarachnoid blood were included as study cases. Then both CTA and DSA were done in order to detect the cause of bleeding and make a treatment planning. All spiral CTAs were performed on a helical CT-Scan. Four vessels DSA were performed via a femoral approach in DMCH Cath Lab. Result: A total number of 37 patients presented with spontaneous subarachnoid haemorrhage were recruited for this study. CT Angiogram revealed aneurysm in 30(81.08%) patients. AVM found in 02(05.41%) patients and in 5(13.51%) patients CTA was negative for any abnormality. DSA of 37 patients revealed aneurysm in 32(86.49%) patients, AVM in 02(05.41%) patients and negative findings in 03(8.11%) patients. In CT Angiogram 25(67.57%) patients had single aneurysm. In DSA, 27(72.97%) patients had single aneurysm. The mean of the size of the aneurysms in CTA and DSA were in 6.70±3.04 mm and 6.75±2.94 mm (p>0.05). The mean of the neck width of the aneurysms in CTA and DSA were 3.86±2.06 mm and 3.41±1.67 mm (p>0.05). All aneurysm detected in CTA were also revealed in DSA. Conclusion: In conclusion the size, neck width and the location of aneurysm are detected in CTA and DSA equally without any statistical significant difference. Journal of National Institute of Neurosciences Bangladesh, July 2022;8(2):121-125

Background: Diagnostic validity of different tests for the detection of spontaneous subarachnoid haemorrhage is an important issue. Objectives: The purpose of the present study was to validate 3D-Computed tomographic angiography in spontaneous subarachnoid haemorrhage. Methodology: This cross-sectional study was carried out in the Department of Neurosurgery and Cath Lab of DMCH in collaboration with private diagnostic centre from September 2013 to February 2015 for a period of six (06) months. Adult patients diagnosed as a case of spontaneous SAH based on clinical features and confirmed by plain CT evidence of subarachnoid blood were included as study population. Patients having current history of trauma, poor clinical grade and agitated patient, patient with renal insufficiency, known allergy to iodinated contrast agent and patients who were not willing participate in the study were excluded from this study. Then both CT angiography and DSA were performed to detect cause of bleeding and to make a treatment planning. In this study DSA was considered as reference standard for evaluation of CTA. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of CTA were calculated per patient basis and per aneurysmal basis. Result: A total number of 37 patients presented with spontaneous subarachnoid haemorrhage were recruited for this study. The mean age of patients was 58.53±7.54 years. Sensitivity and specificity in depicting intracranial aneurysms were, 93.75% and 100% respectively on a per-patient basis. Positive predictive value and negative predictive value of CTA are 100% and 71.43% respectively. CTA had shown 94.59% accuracy in detection of intracranial aneurysm. Sensitivity and specificity in depicting intracranial aneurysms were 94.74% and 100% respectively on a per-aneurysm basis. Positive predictive value and negative predictive value of CTA are 100% and 71.43% respectively. CTA had shown 95.35% accuracy in detection of intracranial aneurysm. Conclusion: In conclusion CTA has high detection capacity of aneurysm among spontaneous subarachnoid haemorrhage patients. Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 47-52

Background: Acute appendicitis can cause morbidity in a large number of people. Objective: The purpose of the present study was to see the socio-demographic characteristics of acute appendicitis patients. Methodology: This descriptive cross sectional study was conducted in the Department of Surgery at Rajshahi Medical College Hospital, Rajshahi, Bangladesh from July 2009 to June 2011 for a period of two years. Patients admitted with features of uncomplicated and complicated acute appendicitis (gangrenous or perforated) underwent emergency appendectomy by grid iron incision in all the units of surgery were selected as study population. All clinical information including history, physical findings and investigation reports were collected and recorded in a pre-designed data collection sheet. Result: A total number of 200 acute appendicitis patients were recruited for this study. Most of the study population were in the age group of 13 to 20 years of age group which was 84(42.0%) cases. The ratio of male and female was 1:1.04. Married were more than unmarried which was 114(57.0%) cases and 86(43.0%) cases respectively. Majority patients of this study was from middle class which was 160(80.0%) cases. Most of the acute appendicitis patients were presented with uncomplicated status which was 136(68.0%) cases and the rest 64(32.0%) cases were in complicated state. Conclusion: In conclusion most of the acute appendicitis patients are young age female coming from middle class family. Bangladesh Journal of Infectious Diseases 2019;6(2):44-47

Background: Prevention of wound infection after appendectomy is very important for the post-operative management of the acute appendicitis patients. Objective: The purpose of the present study was to validate the efficacy of local application of metronidazole solution in the wound after closing of peritoneum in the prevention of appendectomy wound infection. Methodology: This randomized control trial was conducted in the Department of Surgery at Rajshahi Medical College Hospital, Rajshahi, Bangladesh from July 2009 to June 2011 for a period of two years. Patients admitted with features of uncomplicated and complicated acute appendicitis (Gangrenous or perforated) underwent emergency appendectomy by grid iron incision in all the units of surgery were selected as study population. The study population were divided into two groups into group A and group B. In group A (treatment group) after closure of peritoneum the exposed tissue was washed and was flooded with 100ml of metronidazole solution with 5 gm/ml concentration and was waited for one minute and in group B (control group) with the same amount of sterile saline solution. All patients were evaluated daily for evidence of wound infection such as fever, unusual wound pain with recording of pulse, temperature. Suspected wounds were checked on 3rd, 5th and 7th POD routinely after removal of dressing. Result: A total number of 200 patients were recruited for this study and was divided into two groups in equal number. Therefore, 100 cases were in group A and the rest of 100 cases were enrolled in group B. The mean age with SD of group A and B were 25.06±9.14 years and 23.82±7.51 years respectively. Uncomplicated appendicitis was found in 66 cases and 70 cases in group A and B respectively (p>0.05). In metronidazole wound wash group only 5 patients developed wound infection, however, in saline wash group 22 patients developed infection. Among the positive cultures Staphylococcus aureus was 3 cases and Escherichia coli was in 7 cases. Conclusion: In conclusion rate of wound infection is less in the group treated with the local application of metronidazole solution after appendectomy Journal of National Institute of Neurosciences Bangladesh, 2020;6(1): 54-58