Bangladesh Medical Research Council bulletin
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One hundred and four adult cases of cerebral malaria (73 male, 31 female) were studied between July 1995 to June 1996 in Chittagong Medical College Hospital. Diagnosis of cerebral malaria was based on unrousable coma or any neurological manifestation in a febrile patient with asexual Plasmodium falciparum in blood film. Intermittent fever (83%), vomiting (80%), headache (75%), convulsion (60%) and history of travel or residence in malaria endemic area were important features noted in patients with cerebral malaria. ⋯ The factors are more common in cases with high mortality with diastolic blood pressure (DBP) below 60 mm of Hg, anaemia, persistence of Glasgow Coma Score below 5 on day 2, high parasite count at presentation, proteinuria and high level of serum urea. Out of 104 cases of cerebral malaria 66 patients (63.5%) recovered without sequelae, 34 patients (32.7%) died and 4 patients (3.8%) recovered with some residual sequelae. Establishment of intensive care unit in tertiary level hospitals is necessary to take appropriate measure for severe cerebral malaria cases for reduction of mortality.
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Bangladesh Med Res Counc Bull · Aug 1998
Lateral femoral cutaneous nerve block for split skin grafting.
Wound with loss of skin needs grafting for early healing and to prevent deformity and disability. For skin grafting lateral femoral cutaneous nerve block can be used as regional anesthesia. ⋯ The nerve block was found effective in all cases. 90.91% showed excellent results. The procedure seemed to be easy, safe and less costly for the purpose of skin grafting.
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Bangladesh Med Res Counc Bull · Aug 1996
Conduction disturbances in acute myocardial infarction: incidence, site-wise relationship and the influence on in-hospital prognosis.
The study was designed to assess the incidence of conduction disturbances, the relationship of the site of infarction with the type of conduction disturbances and the influence of conduction disturbances on the in-hospital prognosis. One hundred consecutive patients (M:F = 89:11) with a age range of 35-60 years with the history of first attack of acute myocardial infarction were included in the study. There were 45 anterior, 43 inferior and 12 combined anterior and inferior myocardial infarction patients. 44 of the patients had some type of conduction disturbances (Group A) and 56 had none (Group B). ⋯ Mortality rate was higher in anterior myocardial infarction (50%) than in inferior myocardial infarction (25%) when complicated by complete atrioventricular block. It was concluded that conduction disturbances are predominantly atrioventricular in inferior and intra-ventricular in anterior MI; conduction disturbances are associated with increased risk of complications and death. Anterior location of MI may have an independent risk attribute.
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Bangladesh Med Res Counc Bull · Apr 1993
Ketamine infusion for postoperative analgesia: a prospective cohort study in asthmatics.
Ketamine, most often used as an anaesthetic agent can provide adequate post operative analgesia when delivered in the form of infusion, replacing narcotics, which can cause bronchospasm in susceptible individuals. This cohort study was undertaken to assess the feasibility of providing complete post operative analgesia in asthmatics with ketamine delivered in sub-anaesthetic doses (6.10-6.41 ugm./kg.-1/min-1). Diazepam (0.97-1.02 ugm./kg.-1/min-1) was delivered from the same infusion to eliminate the unwanted effects of ketamine. ⋯ Respiratory functions observed, were favourable for asthmatics. Diazepam helped in reducing ketamine induced side effects, but after infusion over long periods tendency of cumulation was observed. Complications encountered were minimum with more than 93% patient acceptability for this method of analgesia.