BackgroundNeurologic disorders are not uncommon at in patient departments of different hospitals. We have conducted the study to see the pattern and burden of neurologic disorders at different inpatient departments of a tertiary care centre.MethodologyThis retrospective observational study was carried out from the records and referral notes of neurology department of Dhaka Medical College Hospital (DMCH) from July 2011 to June 2012. A total 335 patients were evaluated by consultant neurologists during this period.ResultMajority of the patients (59.7%) presented after the age of forty years. The mean age at presentation was 45.11 ± 17.3 years with a male predominance (63.3%). Stroke was the most common condition (47.5%) observed at referral, followed by seizure (9.3%), disease of spinal cord (7.8%) and encephalopathy (6.3%). Even after consultation, 30 patients remained undiagnosed and 6 were diagnosed as functional disorder. Department of Medicine (231, 69%) and Cardiology (61, 18.2%) made most of the calls. More than half (56%) of the stroke patients were referred from medicine and one third (35.2%) from cardiology. Seizure (67.7%), problem in spinal cord (92.3%), coma (50%), encephalopathy (57.1%), motor neuron disease (MND) (72.7%) were common reasons for referral from department of Medicine. Whereas patients with cord disease (7.3%), CNS tumor (40%), seizure disorder (6.5%) and stroke (3.8%) were referred from surgery. Department of Obstetrics and Gynecology sought help for stroke (2.5%), seizure (12.9%), MND (27.3%), coma (16.7%) and encephalopathy (9.5%).Hypertension, diabetes, ischemic heart disease, dyslipidaemia and respiratory problem were significantly associated co-morbid conditions in stroke patients (at 95% CI, p value is <0.001, <0.01, <0.001, <0.05, <0.05 respectively). Hematological disorders were common association among patients with cord problem (<0.05).ConclusionWide ranges of neurological problems are often managed by physicians and surgeons, especially those from medicine and cardiology. Where ever available consultation from neurologists can help in diagnosing and managing these cases.
Background: Hydatid disease is a zoonotic disease caused by Echinococcus granulosus. In humans, lungs are the second common organ involved after liver. Surgical treatment is considered gold standard. Different surgical techniques has developed. However, head to head comparison of these has not yet been done in our country. Methods: A prospective randomized study was done in the Department of Thoracic Surgery, National Institute of Diseases of the Chest and Hospital between July 2004 and June 2006. Patients with pulmonary hydatid disease were offered two surgical techniques, enucleation with or without capitonnage. Group I was offered enucleation of cyst with closure of bronchial opening. Group II was offered enucleation of cyst with capitonnage. Results: 43 patients (age range 7 45 years, mean 25 years) having hydatid disease of the lung were enrolled in the study. Group I involved 23 patients, Group II involved 20 patients. There were 15 males and 28 females. Presenting complaints were chest pain [76.7%], cough without sputum [46.5%], haemoptysis [30.2%], respiratory distress [27.9%], cough with sputum [11.6%] while 23.2% were asymptomatic. The right lung was affected more [65.11%] than left lung [23.3%] and bilateral disease was found in 11%. Postoperatively, in group I, 12.9% developed air-leakage, 4.3% wound infection. In group II, 20% developed air-leakage, 5% haemorrhage and 5% empyema. None of the patient in the former group had to stay in the hospital for >15 days, where as 10% of the latter group had to stay in hospital for >15 days. The hospital stay was found to be significantly higher in the latter group compared to the former group (p < 0.05). There was no significant difference between groups in the development of haemorrhage, empyema, wound infection and broncho-pleural fistula. There was also no significant difference in the rate of recurrence. No anaphylaxis or death occurred in either group. Conclusion: Capitonnage offered no added benefit rather increasing complications. So enucleation followed by closure of bronchial opening may be a reasonable approach. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22702 J Dhaka Medical College, Vol. 23, No.1, April, 2014, Page 94-101
This retrospective observational study aimed to see the angiographic association of atherosclerotic renal-artery stenosis (ARAS) with coronary artery disease in Bangladesh. It was conducted in department of cardiology, University Cardiac Centre, Bangabandhu Sheikh Mujib Medical University, Dhaka from January 2007 to January 2008. A total of 250 patients with coronary artery involvement, on non-emergent coronary angiogram who underwent either selective or nonselective renal angiography were enrolled in this study. Among 250 patients, 52 (20.8%) patient had single vessel disease (SVD), 49 (19.6%) and 149 (59.6%) had double vessel disease (DVD) and triple vessel disease (TVD) respectively. ARAS was detected in 37.2% or 93 patients. ARAS tends to increase with age. In age group of 30-40, ARAS is 7.4% whereas in age group of 51-60 years it is 41%. The incidence of ARAS is high in 50.25±9.98years; p=0.0001. 33.3% male patients with CAD had ARAS whereas it was 44.3% in female patients with CAD. ARAS is more common in female 44.3% vs 33.3%; p=0.02. ARAS prevalence increased with the number of stenosed coronary arteries (3.8% in 1-vessel, 26.5% in 2-vessel, 52.3%in 3-vessel CAD; p=.0001.). Hypertension and angiographically proven CAD were independent predictors of ARAS (p=0.0001). In conclusion, ARAS prevalence and severity increases with the number of arterial territories involved and CAD severity. Hypertension and 2-3-vessel-CAD were identified independent predictors of ARAS.  doi:10.3329/uhj.v4i2.2069 University Heart Journal Vol. 4 No. 2 July 2008 p24-27
Coronary reperfusion with primary percutaneous coronary intervention (PPCI) or fibrinolytic therapy improves outcomes in patients with acute ST elevation myocardial infarction (STEMI) or an MI with a new or presumably new left bundle branch block or a true posterior MI. If performed in a timely fashion, PPCI is the reperfusion therapy of choice compared to fibrinolysis because it achieves a higher rate of TIMI 3 flow. Here we describe a case of acute ST elevated inferior myocardial infarction managed with primary percutaneous coronary intervention as a launching case in the University Cardiac Center ofBangabandhu Sheikh Mujib Medical University. DOI: http://dx.doi.org/10.3329/uhj.v9i1.19518 University Heart Journal Vol. 9, No. 1, January 2013; 67-69
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