Original Articles
Visual Acuity of Children of Darisharifpur Village, Pabna
Abstract Background: Refractive error in children aged 5-15 years is an important public health problem. Myopia and hypermetropia are leading cause of refractive errors in children in this age group. Both which are visually impairing conditions that can be significantly improved through adequate refractive correction. Population based refractive error studies in children have shows that nearly half of the visual impairment associated with correctable refractive error in this age group in not receiving attention specially those children living in disadvantaged social and economic condition Methods: This is an observational study. One hundred children of a village Darisharifpur, upazilla- Bera, district Pabna were studied in Random sampling method. Data were collected from children aged between 9-15 years. Refractive error with other related variables were enclosed with data and and that were analyzed. Results:100 children of village with visual problem or symptoms related to visual acuity were examined and prevalence of refractive error in my study 11%. Myopia (72.72%) is more common refractive error my study, myopia 46%, hypermetropia 25%, astigmatism 27%. Majority (63.63%) of refractive error was found in between -0.50D to -1.99D in my study . In my study majority of refractive errors are within 6/9 to 6/18. Conclusions: Myopia and hypermetropia are leading cause of refractive errors in children in this age group. Both which are visually impairing conditions that can be significantly improved through adequate refractive correction.
- Ahmed Lincoln
- 04 Mar, 2025
Comparative Study of neck swelling by clinical, cytological and histopathological examination – a study of 50 cases
Abstract: Objective: In this study 50 patients of neck swelling were studied to compare the findings with clinical diagnosis and histopathological report for its diagnostic reliability. Methods: This cross sectional study was done in Department of Otolaryngology – Head & Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka from July 2015 to June 2017. Fine needle aspiration cytology, MRI, CT scan, and histopathological examinations of postoperative specimen of neck swelling, presentation of analyzed data by various tables, graphs and figures done. Results: In the present series, 50 cases of neck swelling were studied. Out of these 50 cases 19 were male and 31 were female. The male, female ratio was 1:1.63. Age range was 4 – 60 years with maximum frequency in the 4 th decade with the 3 rd and 2 nd in the following suit. Most of the patient were poor. Clinical, cytological and histopathological diagnosis were available in all the cases. The three sorts of diagnoses were compared with each other. Histopathologically 12 cases were tubercular lymphadenopathy. Metastatic carcinoma and lymphoma, 5 cases for each. 12 were nodular goiter, 5 were thyroid carcinoma. Rest were benign, congenital and nonspecific inflammatory conditions. Correct diagnosis was made by FNAC in 45 cases. In the rest 5 cases, smear were unsatisfactory in 2 cases and gives inconclusive result, remaining 3 were follicular neoplasm and no definitive result were made which were subsequently diagnosed by histopathological examination as a follicular adenoma in 1, and follicular carcinoma in 2 cases. Sensitivity of FNAC in the diagnosis of neck masses were found 91% for tuberculosis, 100% for metastatic carcinoma also for salivary gland tumour. In case of nodular goiter sensitivity was 92%. But it is only 60% sensitive in case of thyroid malignancy, as FNAC cannot demarcate clearly between follicular adenoma and follicular cell carcinoma. But its accuracy in diagnosing papillary cell carcinoma of thyroid was 100%. Conclusion: Keeping the limitations in mind, FNAC can reduce substantially the need of open biopsy for histopathological examination. The study with the popular saying of Stewart “Diagnosis by aspiration is as reliable as the combined intelligence of the clinician and pathologist makes it”.
- Ahmed Lincoln
- 04 Mar, 2025
Factors Related to Respiratory Distress Syndrome in Neonates
Abstract Background: Respiratory distress syndrome of neonates (RDS) is one of the most common causes of neonatal mortality. Objective: The purpose of this study was to investigate socio-demographic, maternal and neonatal factors related to RDS in neonates in context of tertiary level hospital. Methods: This cross sectional study was conducted in Dhaka Medical College Hospital and Ad-din Women’s Medical College and Hospitalduring 1 st January to 31 December 2017 among 186 purposively selected neonates. Data were collected by document review and face to face interview with complete privacy using semi-structured questionnaire and check list. Results: Regarding socio-demographic factors, Considering the maternal factors, majority of the mothers(61.3%) had taken 4 or more checkup during their antenatal period and 87.1% had institutional delivery while approximately half (52.7%) of the mothers had Caesarean delivery. Among the mothers, 17.2% had history of high blood pressure during pregnancy, 10.8% diabetes mellitus, 14% oligohydramnios and 37.1% mothers had PROM. RDS was more common in preterm neonates or below 37 weeks (85.5%) and maximum were low birth weight or below 2500 gram (90.3%), 52 babies (28%) were born of multiple pregnancy, more than half of the babies (62.4%) had moaning sound (grunting) and most of all (92.5%) had chest recession. Conclusion: The factors related to RDS are not preventable but are predictable if ANC for all the mothers can be ensured.If the possibility of occurrence of RDS can be assumed considering these factors, necessary precautions for earlier diagnosis and adequate management can be taken which can contribute in reducing neonatal mortality rate. Keywords: Respiratory distress syndrome, neonatal mortality, intercostals recession, intercostals recession. st
- Ahmed Lincoln
- 04 Mar, 2025
The “Lelli’s Test”: a Screening Clinical Test for the Diagnosis of Anterior Cruciate Ligament Injury
Abstract Background: The anterior cruciate ligament (ACL) is a major knee stabilizing factor during both of the knee’s rotational and anteroposterior stability. ACL damage is a major injury to the knee joint. For identification of ACL injury routinely we practice Anterior drawer test, Lachman’s test and Pivot shift test. In this study we evaluate the accuracy of Lelli’s test for detecting ACL tear and compare it with MRI findings. Methods: This study included 100 patients attending outdoor patient department at Department of orthopedics, Combined Military Hospital (CMH) Bogura from February 2022 to February 2023. aged between 20-60 years with knee symptoms of giving way/locking/pain. Clinical history and detail clinical assessment of knee for instability including Lelli’s test were performed by standard technique and recorded in the Performa. All patients send for MRI of knee and result were compared with Lelli’s test to assess the reliability of clinical test as screening test for ACL injury. Results: In this study total numbers of cases were 100 with mean age was 35 ± 09 years and most of the patients were male 98(98.00%). Maximum injuries occurred on the right side 80 (80.00%). The most common cause of ACL injury was sports activities 85(85.00%) and chief complaints of giving way 82(82.00%). In this study Lelli’s test had sensitivity 94.18 %( CI 70.93-94.57) and Specificity 93.33 %( CI 79.85-97.17) Conclusion: Lelli’s test is a simple with high sensitivity and specificity which can be used as a screening test for evaluation of ACL function in both acute and chronic knee injury.
- Ahmed Lincoln
- 04 Mar, 2025
Percutaneous Dilatational tracheostomy: an Observational Study at Birat Medical College and Teaching Hospital, Kathmandu, Nepal
Abstract: Background: Tracheostomy is the most commonly performed procedure worldwide. It is mainly done in the critically ill patients requiring long term ventilation, facial trauma, laryngeal fractures, laryngeal malignancy, etc. Converting from endotracheal intubation to tracheostomy has many benefits in terms of maintaining the laryngeal function, feeding, safety and it is more comfortable than endotracheal intubation. Tracheostomized patients requires less analgesics and sedatives. It also helps in easier and early weaning from mechanical ventilator, possibility of speech, initiation of oral intake of medication. This all contributes to shorter ICU stay and hospital stay which becomes more cost effective. Methods: This is a prospective observational study that was conducted in the 22 bedded neuro intensive care and medical intensive care unit of Birat Medical College and Teaching Hospital. The data were collected from 1 st Aug 2021 to 28 th Feb 2022. All the patients needing tracheostomy for prolonged intubation, protection of airway and to maintain tracheobronchial toileting was taking under study. Results: Our study was a prospective observational regarding percutaneous dilatational tracheostomy. A total of 71 patients were included in the study. Out of which 39(54.9%) were male and 32(45.1%) were female with the ratio of (1.2:1). The age of the patients ranged from 18-82 years with the mean age of 53.25. The most common indication of percutaneous dilatational tracheostomy was prolonged intubation and that accounted for 29(40.8%) of the patients which was followed by airway protection 27(38%) patients and to maintain the pulmonary hygiene was seen in 15 (21.1%) patients. Conclusion: Tracheostomy is among the most frequently performed procedures in critically ill patients. Percutaneous dilatational tracheostomy is a safe and feasible procedure performed at bedside with minimal invasive technique in ICU.
- Ahmed Lincoln
- 04 Mar, 2025
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