Background : Inguinal hernia repair is very common in day to day general surgical practice. Result of surgical repair is often satisfactory but recurrences following surgery are troublesome both for the surgeon and the patient. Lichtenstein technique is now the most widely performed technique in groin hernia repair.Objective : The aim of this study was to assess short term outcome of complete variety of inguinal hernia repair by Lichtenstein technique. Methodology :This was a prospective observational study in which 30 complete variety of inguinal hernia repairs were performed by Lichtenstein technique between January 2014 and December 2017 by same surgical team in surgery department, Holy Family Red Crescent Medical College Hospital (HFRCMCH). Patients were scheduled for follow up visits at the end of first week, third month and sixth month after operation in out-patient department. The main outcome measures were postoperative complications, early recurrence, groin pain. Result :In this study age of the patients ranged from 30 years to 78 years, the mean age was 51.93 (±SD 10.12) years. Most of the hernia were of indirect type 18(60%) followed by direct type 9(30%). In indirect type (55.6%) of the hernias was right sided and the rest (44.4%) were left sided. On an average each operation lasted for 1.18 hours and oral feeding started 12.69 hours after the operation, Postoperative mean hospital stay that was 2.27 days. Postoperative complications were 2(6.7%) had a prolonged recovery and presented with abdominal distention after operation and 3(10%) patients developed postoperative urinary retention. Scrotal haematoma formation was observed in 2(6.7%) cases and other post operative complications were local haematoma or seroma formation in incision site, periincisional skin echymosis, postoperative pyrexia, superficial wound infection and post operative pain were found in 1 (3.3%) cases. Regarding outcome no recurrence or mesh rejection or mesh infection were observed within short time postoperative follow up period. Conclusion :In this study no recurrence or mesh rejection or mesh infection were observed within short time postoperative follow up period and patient's compliance was good with minimum morbidity. Therefore, Lichtenstein's technique of inguinal hernia repair considered as a safe and effective procedure.
Introduction :Hospital acquired Infections (HAIs) are called those infections that were not present at the time of patient' hospitalization in a hospital and have been acquired after hospitalization. Nurses are an important part of the any healthcare team who play a unique role in the control of Hospital acquired infections.Objective : The aim of this study was to investigate the level of knowledge, attitudes, and practices of staff nurses about preventing the spread of hospital acquired infections (HAIs) at tertiary care Hospital of Dhaka city. Methods and Materials :This descriptive cross-sectional study was done among nurses having two years experience from two tertiary level hospitals in Dhaka city during January to June 2017. Self administered questionnaire containing different set of questions regarding knowledge, attitude and practice on HAI were used as a tool for data collection.Questionnaire was supplied to all staff nurses available at different in-patient wards of these two hospitals. Only 234 staff nurses who completed and returned the questionnaire were included in this study. Data were analyzed using Microsoft excel 2013 software.Result : Staff nurses were found to have good knowledge, moderately positive attitude but poor practice in prevention of hospital acquired infections. About 95% of the participants considered that prevention of HAIs were a valuable part of their role. About 65% of the staff nurses had received formal training regarding hand hygiene. The 100 % of participants felt that they would be less likely to transmit infection to the patients if they performed hand-hygiene. About 64% of them argued that hand hygiene agents were not readily available in current settings. Regarding practice, only 6% performed hand hygiene before patients contact and 27% of the staff nurses reported that they often forgot to perform hand hygiene. Conclusion :The finding of this study revealed a good knowledge of infection prevention among the majority of participants with relatively minimal level of practice. For strengthening the knowledge, attitude and practice towards HAIs, there is in need of developing regular training program and monitoring on performance feedback regarding hand hygiene is recommended.
A large number of patient developed pneumonia of unknown cause in the capital city Wuhan of Hubei province in China during the month of Dec 2019, with clinical presentations greatly resembling viral pneumonia while some rapidly progressed to severe illness and fatal outcome. International Committee on Taxonomy of Viruses (ICTV) named the virus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and WHO officially named the disease COVID-19. World Health Organization (WHO) on January 30 declared the outbreak as a public health emergency of international concern due to rapid global spread. On 11 February 2020, WHO announced that "COVID-19" (meaning coronavirus disease-2019) will be the official name of the disease. This report reviews the genetic structure, infection source, transmission route, pathogenesis, clinical characteristics, and treatment and prevention of the SARS-CoV-2, so that it can provide references for follow-up research, prevention and treatment, and may help readers to have the latest understanding of this new infectious disease. Information have been gathered mainly from relevant researches and papers that were published recently. For this narrative review, more than 49 relevant scientific articles and reports were considered from various databases (e.g., Google Scholar, PubMed and Science Direct) using keywords such as SARS-CoV-2; COVID-19; corona virus; pneumonia; respiratory infection. The results from this review show that the situation is rapidly evolving, as human-to-human transmission is occurring, and the number of new cases and mortalities is increasing by the day and on a global level. There is still ambiguity about mutation risks and how the virus spreads as the source was not yet identified. Major gaps in knowledge about the origin of the virus, epidemiology and transmission impose a great challenge, which emphasizes the need for further studies in the future. There are neither vaccines nor effective treatments for the disease caused by the virus, but efforts are typically confined to symptomatic and supportive management. Antiviral and corticosteroids were used in severe illness but had no effective outcome.
Background: Inguinal hernia repair is a commonly performed general surgical procedure that constitute more than 95% of all groin hernia repairs. However, in developing countries, quite a considerable percentage of it is not repaired or delayed repaired and that lead to a higher incidence of morbidity and mortality. so, we planned to conduct this study to understand the clinic-epidemiologic profile of inguinal hernia in a tertiary care hospital of Bangladesh. Objective: To evaluate the clinical, epidemiological profile and associated risk factors for inguinal hernia. Methodology: This observational study was conducted among 100 patients during January 2018 to January 2019 who admitted in the surgery department of a tertiary care center for inguinal hernia surgery . All the study subjects were examined and their clinical and epidemiological profiles studied, tabulated and analyzed. Result: Among the 100 patients, most of them (94%) were men with a age of 57.02 ± 12.87, farmer (36%) by occupation.61% patients were in low saocio-ecenomic status. Most of the patients (60%) were in the age group of 40-60 years followed by less than 30 years (21%). On query regarding symptoms of inguinal hernia, all of them (100%) complaints of groin swelling. More than half of the patients complaints of groin pain and sensation of heaviness in groin. On clinical examination, right sided, left sided, bilateral hernias were found in 49%,45% and 6% study patients respectively. Direct hernias, indirect, pantaloons hernias were seen in57%,30%,7% study patient respectly. Most of hernias (81%) were reducible and were incomplete (88%). Most of the patients (75%) presented late to the health care center due to the lack of awareness of the disease and were initially treated by homeopath medicine. During query about risk factors for inguinal hernia,46% patients were more than 50 years of age and 26% patients were smoker. In this study, most common hernia repair procedure was Lichtenstein's procedure (63%) followed by modified Bassini's procedure (11%). Total open procedure were 93% and laparoscopic hernia repairs were done only in 7% patients.
Departments of Virology (DVs), BSMMU receive patients from every background, socioeconomic group and health status. Hence, DVs can play a critical role in offering human immunodeficiency virus (HIV) testing and help in the national strategy of early HIV detection. The present study was conducted on 1208 patients attending DVs after taking Institutional Review Board approval. They were screened for HIV antibodies by three rapid/simple assay tests having different principles/antigens as per the WHO guidelines. Forty four (13.6%) of the 1208 patients were HIV reactive and 1164(96.4%) were negative respectively. Distribution of patients on the basis of gender where 894 (74.1%) were male and 313 (25.9%) were female out of 1208 patients or clients. Distribution of study subject on the basis of exposure history where 378(38.8%) patients or clients had history of exposure and 830 (68.7%) patients or clients did not. Distribution of the patients on the basis of purpose of screening where patients were in three groups (Screening before operation, Positive exposure history and To exclude HIV infection during failure of drug Rx) where 776(64.2%) patients were done anti-HIV test due to screening purpose before operation, 378(31.1%) patients were done this test due to Positive exposure history exposure history and 54(4.5%) patients done this due to exclude HIV infection during failure of drug treatment. Prevalence of HIV infection was more among 21-40yrs age group than other age group(18mon-20yrs,41-60yrs&>60yrs) which is not significant . Data shows there was significant association of anti-HIV positivity with exposure history of the patients or clients. Prevalence of HIV infection was more among patients or clients who had history of exposure. Prevalence of HIV was more among the patients who were done screening test due to failure of drugs than other two purposes. Bangladesh is still considered as a low HIV/AIDS prevalent country. However, it is at a critical moment in the course of its AIDS epidemic. It is estimated that there are 13,000 HIV-positive people in the country and that HIV prevalence in the adult population is less than 0.01%. However, the country's vulnerability is very high. National HIV surveillance indicates that the rate of HIV infection among street-based sex workers in central Bangladesh is high compared with sex workers in other parts of South Asia. HIV among injecting drug users is already 10.5%.The presence of covert multi-partner sexual activity and denial, the low level of knowledge and low condom use, unsafe professional blood donations, lack of a desirable environment and violation of Human Rights, all contribute to the spread of HIV in Bangladesh. Thus, the study emphasizes the need for expansion of routine voluntary HIV counseling and testing to all the patients who come to the DV and practicing universal work precautions by health care workers.
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