Mymensingh medical journal : MMJ
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Randomized Controlled Trial
Effects of therapeutic modalities on patients with post stroke shoulder pain.
A randomized clinical trial was conducted to find out the effects of physical modalities transcutaneous electrical nerve stimulation (TENS) and ultrasonic therapy (UST) on the patients with post stroke shoulder pain in the Department of Physical Medicine & Rehabilitation & Department of Neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU) from 1st July 2006 to 31st December 2006. In that period a total of 750 stroke patients attended the stroke clinic of the Department of Neurology, BSMMU, of which 150(20%) patients presented with post stroke shoulder pain. Among the patients with post stroke shoulder pain, 45(6%) patients were included in the study. ⋯ Significant improvement was observed after treatment in each group except in active internal rotation in UST group. But in comparison between two groups, Group A (TENS) showed statistically significant better improvement in all planes of pain free range of motion than Group B except active abduction which was better improved in group B (UST) and in case of passive abduction, passive external rotation and passive extension, TENS had better effect than UST. It may be concluded that TENS and UST both are effective but TENS may be safer and superior to ultrasonic therapy (UST) in the treatment of the patients with post stroke shoulder pain.
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Comparative Study Controlled Clinical Trial
Procedural sedation in children for magnetic resonance imaging--comparison between ketamine diazepam combination with midazolam fentanyl combination.
A deeper level of sedation by an anaesthesiologist is requirement for magnetic resonance imaging (MRI) in paediatric populations and sedation of children is different from sedation of adults. The purpose of the study was to compare the efficacy, safety, tolerability and cost effectiveness of ketamine, diazepam combination to midazolam, fentanyl combination for sedation of children during MRI. One hundred twenty children of both sex, age between 1-10 years, American Society of Anesthesiologist (ASA) physical status I and II were distributed into two groups. ⋯ Every child of both groups was discharged to home. Sedation regimen of group B found 5 times more costly than group A. Both the regimens were found safe and effective for paediatric sedation during MRI but ketamine, diazepam combination found more cost effective which, is a considerable matter in Bangladesh.
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Controlled Clinical Trial
Evaluation of simple hematological screen for early diagnosis of neonatal sepsis.
This prospective study was undertaken in Dhaka Shishu Hospital from 15th March 2005 to 15th October 2006 to evaluate the role of simple hematological test for early diagnosis of neonatal sepsis. Eighty suspected cases of septicaemia admitted in neonatal ward of Dhaka Shishu Hospital were included in this study. Patients those who had history of perinatal asphyxia, infant of diabetic mother, congenital cyanotic heart disease etc. were excluded from the study. ⋯ Those who had no signs of sepsis were categorized as control group. Absolute neutrophil count (ANC) had low sensitivity (13%) but Micro-ESR, CRP, I/T ratio, platelet count had moderately high sensitivity and specificity. These simple hematological screen are useful marker for early diagnosis of neonatal sepsis.
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Anaesthesia for parturient patients with dwarfism is an uncommon problem faced by anaesthesiologists. There is an ongoing debate regarding general versus regional anaesthesia in these cases. In many centers there is lack of facilities for epidural or continuous epidural anaesthesia. ⋯ We have managed the case by sub-arachnoid block (SAB) using 7.5 mg (1.5 ml) of 0.5% heavy bupivacaine at a level of L3-L4 interspace having adequate level of block and analgesia. The case was managed successfully and uneventfully. In this presentation, the role of SAB and a management guideline has been highlighted.
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Case Reports
Back pain and vertebral compression: an unusual presentation of childhood acute lymphoblastic leukemia.
Junayet, a nine years and six months old boy was admitted to the hospital because of back pain and vertebral compression fractures. The boy had been well until two months earlier, when he began to have back pain after falling on his back along with occasional fever. The pain was intermittent initially but gradually it became constant. ⋯ Then, he was started protocol based chemotherapy for induction of remission, consolidation, high dose methotrexate and maintenance therapy. Now, he is on regular follow up with repeated hematological and radiological examinations. Following six month of chemotherapy the boy was found with significant improvement of his physical, hematological and radiological abnormalities.