Introduction:
Paraquat is a N,N2 -dimethyl-4,42 -bipyridinium dichloride (systematic name) is
an or...
Introduction:
Paraquat is a N,N2 -dimethyl-4,42 -bipyridinium dichloride (systematic name) is
an organic compound with the chemical formula [(C6H7N)2]Cl2. It is classified as
a viologen, a family of redox-active heterocycles of similar structure.It’s used widely
in our country and is a highly toxic compound.
It is first discovered in 1950 and used in agriculture by 1962.It is rapidly absorbed by
the aerial plant and immediately inactivated in contact to the clay in the soil leaving
minimal residue. Being cheap and effective, paraquat is unregulatedly used in third
world countries as herbicide.
Paraquat is commercially available in Bangladesh as a bio-pesticide in 2 formulations
– 20% paraquat and 20% paraquat plus 41% glyphosate combination.As Paraquat is
widely available in rural Bangladesh for its agricultural use, it has grown to be the
major medium of self-harm over the years.
1
Paraquat poisoning can manifest as acute and chronic toxicity. The acute effects can
result in both local and systemic manifestations. Local effects include ulceration of
the skin, lips, tongue, pharynx, and esophagus. Systemic effects involve multiple
organ failure, including liver insufficiency, acute kidney injury, respiratory failure,
and convulsions.
2
Abstract:
Background: Acute Lymphoblastic Leukemia (ALL) is the most common cancer in children
with...
Abstract:
Background: Acute Lymphoblastic Leukemia (ALL) is the most common cancer in children
with an improved outcome at present. Because of its increased cure rate (almost 80%), more
emphasis has been placed on reducing the toxicities of therapy, improving quality of life (QoL)
during treatment and minimizing the long-term effect of therapy. So, the study was aimed at
understanding QoL during different phases of chemotherapy.
Methods: This cross-sectional study was conducted from 1st April, 2011 to 30th September,
2011 in the Department of Pediatric Hematology and Oncology, Bangladesh Medical University,
Shahbag, Dhaka. Total 42 Children of 2-16 years with ALL were included in this study. QoL
scores were collected using the Pediatric Quality of Life Inventory™ (PedsQL™) 4.0 Generic
Scale and the Pediatric Quality of Life Inventory (PedsQL™) 3.0 Cancer Module proxy
report. Medical and demographic data were collected from medical records and interviewing
guardians. Data were processed and analyzed by using the SPSS (version 17.0).
Results: PedsQL overall 62.03 (range 58.28-64.69), physical score 67.22 (range 53.13-71.88),
psychological score consisting of emotion, social and school score was 60.00 (range 56.6760.00),
emotional score 72.50 (range 70.00-80.00), social score 100 (range 90.00-100.00) and
school
score 2.5 (0.0-20.0). Social score was best but school score was worst. Here no predictor
was
found that significantly worsened QoL. Scores were similar in different phases of
treatment.
Conclusion: QoL in children with ALL has been described and there are no predictors of
worse QoL. QoL was also similar in different phases of treatment. School summary score was
worst, so special attention should be provided to improve the schooling of children.
Abstract:
Introduction: Young women are primarily affected by lupus nephritis, which is linked to
sy...
Abstract:
Introduction: Young women are primarily affected by lupus nephritis, which is linked to
systemic lupus erythematosus and can seriously harm the kidneys if left untreated. Urine
neutrophil gelatinase-associated lipocalin (NGAL) has become a viable non-invasive biomarker
due to the invasiveness of renal biopsy. NGAL levels provide crucial information about
kidney damage and the efficacy of therapy by indicating the severity of the disease and the
response to treatment.
Materials & Methods: A prospective observational study was conducted at BSMMU,
Dhaka, between March 2023 and August 2024. Fifty-two adults with biopsy-proven lupus
nephritis were enrolled. Clinical characteristics, urinary NGAL levels, biochemical parameters,
and renal histopathology were recorded at baseline and reassessed after six months of therapy.
Results: The study predominantly involved young females (92.3%), with 69.2% under the
age of 30 and 67.3% having a normal weight. A majority were married (80.8%) and resided
in urban areas (57.7%). Histologically, 57.7% of participants had class IV lupus nephritis.
All patients were treated with Hydroxychloroquine, while 61.5% also received
Cyclophosphamide plus Corticosteroids, 23.1% received MMF plus Corticosteroids, and
15.4% were treated with only Corticosteroids. A complete response was achieved by 67.3%
of the patients. Urinary NGAL levels, a marker of renal inflammation, were highest in patients
with class IV lupus nephritis, both at baseline (2.14 ± 1.01 ng/mL) and at 6 months (1.20 ±
0.59 ng/mL), with a significant correlation to disease severity (p < 0.05). Patients with
proliferative lupus nephritis had higher urinary NGAL, elevated serum creatinine, and
lower serum albumin levels compared to those with non-proliferative lupus nephritis. Those
who experienced a complete response exhibited lower NGAL levels at both baseline (1.39 ±
0.48 ng/mL) and 6 months (0.80 ± 0.25 ng/mL).
Conclusion: The study highlights the potential of urine NGAL as a valuable biomarker for
evaluating disease severity and treatment outcomes in lupus nephritis, suggesting that it
could enhance clinical management and inform therapeutic decisions. However, further largescale,
multi-center studies are required to validate its use in routine clinical practice.
Abstract:
Background: Large bladder stones can cause significant morbidity and typically require...
Abstract:
Background: Large bladder stones can cause significant morbidity and typically require active interventions. Pneumatic lithotripsy using a perurethral nephroscope is a minimally
invasive and cost-effective treatment option. This study aimed to evaluate the efficacy and
safety of treating large bladder stones using a perurethral nephroscope combined with
pneumatic lithotripsy.
Methods: This cross-sectional study was conducted at Pabna Medical College Hospital and affiliated private hospitals from February 2020 to January 2025. Twenty-three patients with large bladder stones (³3 cm) were enrolled. All patients underwent stone fragmentation using pneumatic lithotripsy with a perurethral nephroscope. Operative time, hospital stay, catheterization duration, and complications were also documented. Data were analyzed using
SPSS version 25.0, with significance set at p<0.05.
Results: The mean age was 52 ± 12 years, and 87.0% of the patients were male. The average
stone size was 4.1 ± 0.6 cm in diameter. The mean operative time was 48.5 ± 12.0 minutes,
with an average hospital stay of 1.6 ± 0.5 days. All patients were stone-free after the procedure.
Minor complications occurred in 26.1% of the cases, including hematuria (13.0%), urinary
retention (8.7%), and fever or stricture (4.3% each). No major complications were noted.
Conclusion: Perurethral nephroscopy with pneumatic lithotripsy is an effective, safe, and minimally invasive technique for managing large bladder stones, particularly in resourcelimited settings.
Abstract:
Background: Minimally invasive approaches are a more recent development, which aims at...
Abstract:
Background: Minimally invasive approaches are a more recent development, which aims at
reducing damage to soft tissues. The subvastus or Southern approach to the knee had been described as early as 1929. This approach for primary total knee arthroplasty (TKA) preserves the integrity of the extensor mechanism and maintains the vascular supply to the patella. It provides excellent exposure of the knee joint with preservation of all peri-articular soft tissues. The benefits of the subvastus approach make it a valuable technique for primary TKA. This
combination of advantages ensures rapid recovery, better knee range of motion and finally excellent patient satisfaction.
Aim of the study: The goal of this study is to compare the subvastus method to the usual medial parapatellar technique for total knee replacement in patients with osteoarthritis based on quadriceps function recovery in days after surgery.
Methods: We retrospectively reviewed case notes of 36 patients with osteoarthritis who had total knee replacements in satkhira medical college hospital and private clinics over the course of a period from August 2019 to August 2024.we evaluated all the cases regarding early postsurgical clinical outcomes (range of motion [ROM], pain on a visual analog scale, and
Knee Society Score [KSS]). Preoperative quadriceps strength, BMI, and baseline demographics were all recorded from their initial pre-operative workup case notes. Starting on the first postoperative day, patients recorded first unassisted straight leg raise (SLR) was kept as the main determinant for muscle function. The data were evaluated to determine the quadriceps
muscle function post TKR.
Result: When compared to the medial parapatellar approach, the quadriceps muscle function returns sooner with the subvastus technique. Patients in their sixties showed the highest improvement. Preoperative quadriceps strength has a major impact on muscle recovery after surgery.
Conclusion: The subvastus method to total knee replacement is linked to a faster recovery of
quadriceps muscle strength, resulting in a shorter hospital stay and postoperative therapy.
Abstract:
Background: Laparoscopic cholecystectomy (LC) is the standard treatment for symptomatic...
Abstract:
Background: Laparoscopic cholecystectomy (LC) is the standard treatment for symptomatic gallstones. The initial abdominal entry, critical to safety, employs either blind trocar entry (BTE) or the Hasson method. This study compares these techniques in 100 patients.
Methods: A single-center randomized controlled trial allocated 100 patients to BTE (n=50) or Hasson (n=50). Outcomes included operative time, complications (visceral/vascular injury,
extraperitoneal insufflation), conversion rates, and hospital stay. Statistical analysis used tests
and chi-square.
Results: Hasson had a longer mean operative time (47.5 ± 8.2 vs. 42.3 ± 6.5 minutes;
p=0.001) but fewer major complications, such as Visceral injury (Hasson 0% VS BTE 4%
p=0.04 and vascular injury Hasson 0% VS BTE 2%; p=0.32. BTE had higher visceral injury
rates (4% vs. 0%, p=0.04). Hospital stay and conversion rates were comparable.
Conclusion: The Hasson method reduces complications at the expense of slightly longer
operative time, advocating its use in high-risk patients.
Abstract:
Background: Hemorrhoids are important today due to rising sedentary lifestyles, poor d...
Abstract:
Background: Hemorrhoids are important today due to rising sedentary lifestyles, poor diets, and stress, leading to increased cases, healthcare costs, and demand for awareness and effective treatments.
Objective: My study has a goal to analyze the success of rubber band ligation in hemorrhoids of grade I, II, Ill,to analyze their complication and to see if all symptomatic hemorrhoids should be treated with band ligation at first visit
Methods: A prospective and descriptive study was designed for patients who came to OPD
of Chittagong Medical College Hospital from July 2007 to June 2008. Patients having large 1st
degree hemorrhoids, 2nd degree and early 3rd degree hemorrhoids were treated.
Results: Rectal bleeding was the most common symptom (100%). Anoscopy showed 6% first
degree, 86% second degree and 8% third degree hemorrhoucis. information on piresentnng
symptoms, number of bands applied response to therapy, complications encounteredJ Inumber
of sessions needed to improve the symptoms, requirement of analgesks, follow-up of the
patients, subsequent therapy were documented. Supplementary information was obtained
over telephone follow-up. Outcome was categorized as success or failure in which success has
been defined as permanent relief of symptoms within follow-up periods. Improvement in
symptomatology means rare manifestation of bleeding(< 1 month). Failure has been defined as
decrease but no improvement of symptoms. In this study, 88% patient succeeded, 6% improved
and 6% failed. 16% patient had bleeding during defecation < 7 days, 8% patient complaints
bleeding > 7 days. Recurrence observed in 2% patients. 38% patients required no analgesics.
Among the 62% patients who required analgesics 36.8% required for up to 24-hours, 47.37%
required for 24-48 hours and 3- patients needed for > 48 hours. All patient attended first
follow-up at 7th day, 14% missed second follow-up at 6 weeks and 16% missed third followup
at 6 months.
Conclusion: Rubber band ligation is a quick, simple procedure requiring no anesthesia, in
absence of anorectal pathologies other than hemorrhoids. Though it has some minor
complications and chance of recurrence, it is considered as a safe and effective procedure for
symptomatic hemorrhoids.
Abstract:
Introduction: Anaesthesia management plays a critical role in ensuring patient safety and...
Abstract:
Introduction: Anaesthesia management plays a critical role in ensuring patient safety and comfort during and after surgical procedures. The choice of anaesthesia type—whether regional or general—can significantly influence the incidence of complications and overall patient recovery. This study aimed to evaluate anaesthesia practices, monitor complications, and assess patient satisfaction among individuals undergoing various types of surgery.
Methods:
The study was conducted at General Hospital, Pabna, Bangladesh from 1st October 2023 to 30th September 2024. Data were collected from medical records of patients who underwent surgery at a hospital. The study population consisted of 42 individuals, with a higher proportion of females and the largest age group being 18-40 years. Data analysis was performed using SPSS version 26.
Result:
The results of this study indicate that 57.1% of patients received regional anaesthesia, while 42.9% were administered general anaesthesia. Monitoring
techniques, including pulse oximetry, ECG, and blood pressure, were widely used, with complications occurring in 33.3% of the population. Post-naesthesia complications were most commonly nausea (42.9%) and hypotension (4.8%). Satisfaction with anaesthesia was high, with 95.2% of patients reporting satisfaction. A significant negative correlation (-0.361, p=0.0188) was found between general anaesthesia and the absence of complications.
Conclusion:
The findings from this study indicate that regional anaesthesia is associated with fewer post-anaesthesia complications compared to general anaesthesia, as evidenced by the negative correlation between the two. The statistically significant p-value of 0.0188 (p < 0.05) underscores the meaningful association between the type of anaesthesia and the
occurrence of post-anaesthesia complications.
Abstract:
Background:
Split-thickness skin grafting (STSG) is a cornerstone in reconstructive s...
Abstract:
Background:
Split-thickness skin grafting (STSG) is a cornerstone in reconstructive surgery. The Humby knife and shaving blade are two techniques for harvesting grafts, but their comparative efficacy remains understudied. This trial evaluates outcomes of both methods in
100 patients.
Methods:
A single-center RCT (2021–2023) 100 patients dividing 2 groups, having procedure of Humby knife (n=50) and shaving blade (n=50). Primary outcomes included graft take rate and complications; secondary outcomes were operative time, pain scores, and cosmetic results. Statistical analysis used t-tests, chi-square, and multivariate regression.
Results:
The Humby knife group had higher graft take rates (94% vs. 82%, p=0.03), lower infection rates (4% vs. 14%, p=0.04), and superior cosmesis (Humby : 6% vs. Shaving 18% (p=0.03%). Operative time was longer for Humby (28.5 ± 4.1 vs. 18.2 ± 3.8 minutes, p<0.001).
Conclusion:
The Humby knife offers superior graft survival and cosmetic outcomes despite longer operative time, advocating its use in critical reconstructive cases.
Abstract:
Background: Distal radius fractures are common, with volar Barton fractures posing a uniq...
Abstract:
Background: Distal radius fractures are common, with volar Barton fractures posing a unique challenge due to their intra-articular nature and instability. These injuries often result from high-energy trauma and involve dislocation of the radiocarpal joint. Conservative treatment frequently yields poor outcomes, prompting a shift toward surgical management. Volar buttress plating via open reduction and internal fixation (ORIF) has emerged as the preferred approach, offering stable fixation, early mobilization, and favorable functional recovery.
Anatomically contoured low-profile plates enhance outcomes by minimizing soft tissue complications. Despite some risks, such as tendon irritation, clinical results have generally been positive when appropriate surgical protocols are followed.
Aim of the study:
This study aims to evaluate the treatment outcomes of volar Barton fractures of the distal radius managed with volar buttress plates.
Methods:
This prospective observational study was conducted over 12 months, from July’23 to June’24 at the Department of Orthopaedics of Pabna Medical College, Bangladesh to evaluate outcomes of volar Barton fractures treated with open reduction and internal fixation using a volar buttress plate. Thirty (30) adult patients with closed, radiologically confirmed Volar Barton fractures were included. The surgery involved a standard volar (Henry’s) approach with fixation using locking or non-locking screws. Postoperative care included early mobilization and radiographic follow-up at 2, 6, and 12 weeks postoperatively. Outcomes were assessed radiologically and functionally using the Mayo Wrist Score. Data were analyzed descriptively using SPSS version 26.0 without inferential statistics. Results: In this study of 30 patients with volar Barton fractures treated using buttress plate fixation, most were males (70%) aged 30–50 years (53.33%), with the right hand predominantly affected (93.33%). The primary cause was falls on an outstretched hand (56.67%). Radiographic union occurred within 6–12 weeks in 70% of cases, and final alignment was maintained in 90% of cases. Functional assessment using the Mayo Wrist Score showed excellent to good outcomes in 86.67% of patients. Complications were minimal, including superficial infection (3.33%), tendon irritation (3.33%), and implant prominence (6.67%).
No cases of deep infection, implant failure, or reduction loss were reported.
Conclusion:
Volar buttress plate fixation is an effective treatment for volar Barton fractures, promoting early union, stable anatomical reduction, and good functional recovery with minimal complications. Optimal outcomes depend on selecting the appropriate patients, performing surgery promptly, and employing precise surgical techniques.
