Mymensingh medical journal : MMJ
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An elderly emaciated female patient presented with recurrent lower abdominal pain associated with nausea and vomiting due to obstruction of the small bowel. Although the Howship-Romberg sign and tender mass on digital rectal examination could not ascertained but plain X-ray abdomen shows features of acute intestinal obstruction. After resuscitation laparotomy was done and diagnosed as case of strangulated obturator hernia of Ricters type. ⋯ Abdomen closed in layers keeping a drain in right iliac fossa and pelvic cavity. The postoperative recovery was uneventful. Patient discharge with advice on 9th postoperative day.
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Prospective study was carried out on 100 patients since May 2005 in my private practice and in the department of pediatric surgery of MMCH. Under caudal anesthesia along with or without ketaminie induction and gas inhalation all the patients underwent different surgical procedure namely anorectal surgery (eg. anoplasty, rectal polyp), urogenital surgery (Circumcision, hypospadias, meatotomy), groin surgery (hernia, hydrocele) and foot & leg surgery. Calculated dose schedule of drugs used in anesthesia and volume were maintained. ⋯ Per-operative and postoperative analgesia were evaluated. Every parent was explained regarding the merit of caudal anesthesia calculated and compared with that of general anesthesia. Application of caudal anesthesia with or without ketamine & diazepam induction can be used safely and cost effectively and may be put into protocol in many of the pediatric surgical practice both in institute and also in private practice.
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Proteinuria helps to establish the diagnosis of most renal diseases and also to predict the outcome of such diseases. Proteinuria is biochemically represented by measuring the protein concentration in timed collection of 24 hour urine. But, 24-hour timed urine collection is time consuming, cumbersome and often unreliable due to collection errors and also results in undue delay on diagnostic process. ⋯ Severe CRD patients gave significant positive correlation (p<0.05), whereas mild and moderate CRD patients gave very highly significant positive correlation (p<0.001). Therefore, it may be suggested that protein creatinine ratio in spot morning urine can be accepted as a reliable and alternative to 24-hour UTP excretion rate in non-diabetic chronic renal disease patients. This simple and inexpensive procedure will thus simplify the way of establishing the severity of renal disease along with its prognosis.
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To assess the knowledge of the motor vehicle driver about the causes of road traffic accidents. This cross sectional study was conducted among the 107 motor vehicle drivers of selected Bus & Truck terminal & taxi stands of Dhaka city. The study was carried out during April to June 2002 at the Department of Health Promotion & Health Education of NIPSOM. ⋯ Majority of the driver who took part in this study used light vehicle 54.2% and the rest 30.8% were heavy and 15% like medium light vehicle. Most of the respondent 67.3% was working as professional over for 3-6 years. 41.1% for 3 and 26.2% for 6 years. There were significant relationship (p < 0.002) between very fast driving and defective road and also engine defect were highly significant association (p < 0.005) with road traffic accident It is revealed that formal education, driving license through Bangladesh road traffic authority without unnecessary botheration, proper implementation of traffic law, training of drivers and increase level of public awareness through mass communication could reduce the road traffic accident
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Obesity infrequently associated with type 2 diabetes mellitus and may cause insulin resistance, hypertension and other complications of obesity. So obesity management in Type 2 diabetes mellitus is essential. ⋯ The obese diabetic patient faces extra impediments to weight loss, including the adverse effects of diabetic medication, poor glycaemic control and diabetes related complications. New drugs may offer some additional help, in general by providing the benefit associated with the weight loss as such, Bariatric surgery can produce major long-term weight loss in the severely obese subjects.