A prospective study was conducted on 54 cases of neonatal intestinal obstruction, admitted in Paediatric surgery department of Rajshahi Medical College Hospital during the period from January 2008 to December 2008, a period of 12 months. The objective of the study was to find out etiological aspect and outcome of admitted patient with neonatal intestinal obstruction. The patient constituted 33.7% of total neonatal admission in Paediatric surgery department during the study period. The male: female ratio was 1.4:1 with age ranging from 1 to 28 days. Birth weight of most of the patients was above 2 kg. Most of the patients came from poor and average family. Patients from poor family are slightly ahead. Plain x-ray abdomen was done in all cases in our study. Contrast radiography performed in selected cases. Ultrasound scan done to in selective case to rule out IHPS. No rectal biopsy was taken in case of suspected Hirschsprung's disease. The causes of neonatal intestinal obstruction were in order of frequency-Hirschsprung's disease (45.2%), Intestinal atresia (24.5%), malrotation (9.4%), bands & adhesion (5.6%), meconium ileus (5.6%), volvulus neonatarum (5.6%), meconium plug syndrome (1.8%), unknown (3.7%). 50 patients were treated operatively. 28.3% cases developed complications. Most of the complications were related to colostomy and sepsis. Overall mortality was 20.8%. Mortality was maximum in intestinal atresia. Every patient was advised to come for follow up at the time of discharge but most of the people did not report. In the study only 17 (32.1%) patient came for follow up as per advice.TAJ 2009; 22(1): 198-203
Background: Intracranial stenosis is the most common cause of stroke among Asians. It has a poor prognosis with a high rate of recurrence. No effective medical or surgical treatment modality has been developed for the treatment of stroke due to intracranial stenosis. We aim to identify risk factors and biomarkers for intracranial stenosis and to develop techniques such as use of transcranial doppler to help diagnose intracranial stenosis in a cost-effective manner.
Seventy four patients of pyogenic liver abscess prospectively evaluated by clinical, haematological, microbiological and sonographic methods. The main objective of this study was to find out correlation between intake of indigenous alcohol and to identify class population affected. Most of the affected patients of pyogenic liver abscess are lower and middle class male and who are farmer with mean age 37±11.7 years. Our study reveals '59 (80%) cases consume that alcohol, among them 56 (95%) patients took locally prepared alcohol (TARI). Organism recovered from pyogenic liver abscess vary considerably. Escherichia coli has been the organism most commonly isolated in our study. 57 cases were treated with ciprofloxacin and sonographic guided needle aspiration. Ciprofloxacin still remains as the drug of choice for this disease and recovery was excellent. So the study reveals that indigenous alcohol is associated with the development of pyogenic liver abscess.
A descriptive study on all cases of haematemesis and or melaena was carried out at Rajshahi Medical College Hospital to observe the demographic profile, clinical presentation, cause and outcome of upper gastrointestinal bleeding in a tertiary hospital of Bangladesh. Fifty adult patients presenting with haematemesis and or melaena admitted consecutively into medical unit were evaluated through proper history taking, thorough clinical examination, endoscopic examination with in 48 hours of first presentation and other related investigations. Patients those who were not stabilized haemodynamically with in 48 hours of resuscitation and endoscopy could not be done with in that period were excluded from this study.Results our results showed that out of 50 patients 44 were male and 6 were female and average age of the patients was 39.9 years. Most of the patients were from low socio-economic condition. Farmers, service holders and laborers were the most (57%) affected group. Haematemesis and melaena (42%), only melaena (42%) and only haematemesis (16%) were the presenting features. Endoscopy revealed that duodenal ulcer( 34%) was the most common cause of UGI bleeding followed by rupture of portal varices( 16%) , neoplasm( 10%) , gastric ulcer ( 08%) and gastric erosion( 06%).Acute upper GI bleeding is a common medical problem that is responsible for significant morbidity and mortality. The extensive clinical spectrum of gastrointestinal bleeding may encompass many different clinical scenarios. It is often very difficult to find out the cause and site of bleeding. We find that though cases of ruptured oesophageal varices were increasing, still peptic ulcer disease is the leading cause of haematemesis and melaena.
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