ORIGINAL RESEARCH ARTICLE | March 12, 2022
Evaluation of Single Verses Multiple Doses of Suxamethonium in Rigid Bronchoscopy: A Tertiary Care Hospital Study in Bangladesh
Dr. Md. Rejaul Hasan, Dr. Shawkat Mahmood, Dr. Sayeda Begum Panna, Dr. Md. Shamim Hossain Apel, Dr. Mohammad Zohanul Islam
Page no 127-131
Background: Rigid bronchoscopy is frequently required in the therapeutic therapy of a wide range of tracheobronchial diseases. Suxamethonium is a common neuromuscular blocking medication used for rapid sequence tracheal intubation because of its quick onset and recovery. Objective: The objective of the study was to evaluate the effects of single vs multiple doses of Suxamethonium in rigid bronchoscopy. Methodology: This randomized cross-sectional observational study was conducted from January 2019 to December 2020 among 180 patients in a tertiary care hospital of Bangladesh. Data on certain basic parameters were obtained on the basis of the clinical records and related changes. Collected data were displayed in tabular and graphical form in terms of different parameters, and statistical analysis was conducted to observe the statistical significance. Results: In this study, we divided patients into 2 groups (Group 1: Single dose Suxamethonium, Group 2: multiple-dose Suxamethonium). Among 180 patients, a maximum (34.4%) patients were more than 50 years of age. Also, 58% were male, and 42% were female patients. Here, maximum patients (33.8%) had a cough, while minimum patients (2.7%) had chest pain. Among group 1, maximum patients (39.1%) had mild fasciculation scores and minimum patients (7.4%) had zero scores. Among group 2 patients, maximum patients (24.3%) had zero fasciculation score, and minimum patients (6.3%) had vigorous scores. According to the Copenhagen scoring system, in group 1, 47.40% of patients had an excellent outcome, and 6.65% of patients had a poor outcome. And in group 2, 74.7% of patients had a good outcome and 13.50% of patients had an excellent outcome. In both groups, maximum patients had minor bleeding, vocal cord trauma, and hypoxia. Conclusion: The findings imply that single-dose Suxamethonium was more effective in improving patient satisfaction. The intubating settings would be more pleasant if single-dose Suxamethonium was used.
CASE REPORT | March 12, 2022
Alternaria sp Mycotic Keratitis: A Case Report
Soukaina Adadi, Ouahiba Bhalil, Bilal Moumni, Hayat Ben-Saghroune, Zineb Tlamçani
Page no 132-134
Keratitis is a frequent pathology in everyday ophthalmology, whose etiologies are dominated by bacterial origin. The mycotic origin is a rare cause, and the prognosis is usually reserved, given the delay in diagnosis, mainly due to self-medication. We present a case report concerning a 60 year old patient who presented a mycotic corneal abscess due to Alternaria sp . He presented a stromal infiltration of the cornea of the left eye on biomicroscopic examination. A swab of the abscess was performed for mycological study which came back positive for Alternaria sp . On the basis of the clinical manifestations and conducted examinition, a diagnosis of Alternaria mycotic keratitis was established.
ORIGINAL RESEARCH ARTICLE | March 13, 2022
Clinical and Neurophysiological Characteristics of Patients with Carpal Tunnel Syndrome Presenting at the Tertiary Rheumatology Out-Patient Clinic
Dr. Akintayo Segun Oguntona, Dr. Ricardo Morasen Cuevas Jose, Dr. Mazwa Hussein
Page no 135-140
Background: Carpal tunnel syndrome (CTS) is the most commonly-encountered entrapment neuropathy. The classic symptoms of CTS are numbness and paraesthesia in the first three fingers of the hand, which is commonly exacerbated at night. The diagnostic signs include sensory loss along the lateral aspect of the hand, motor weakness and wasting of abductor pollicis brevis muscle. Tinel’s and Phalen’s signs are elicited at the wrist. Methods: This is a prospective analysis of clinical and electrophyisologic study performed on patients that attended the rheumatology outpatient clinic of a tertiary institution. The primary patients of the unit and those that were referred to the rheumatology clinic on account of clinical features of CTS were included in the study. Excluded from the study were pregnant women and those with previous history of CTS surgery. Nerve conduction study was carried out on all patients with features of nerve compression at the wrist. Results: Sixty nine (69) patients out of 82 that presented with clinical features of CTS were diagnosed of CTS. Females constituted 84.1% (58) and males were 15 .9% (11). The most affected age group was (31-40) years. Diabetes patients had the highest presentation of CTS (42%). The classic history of CTS was reported in 33.3%, Paraethesia was observed in 46.4%, numbness in 44.9% while paraethesia and numbness together were reported in 40.6% of patients. Day pain and nocturnal pain was seen in 60.9% and only nocturnal pain was reported by 42.0%. Abductor policis brevis (APB) muscle weakness was found in 24.6% of patients while 11.65% had wasting of the muscle. Conclusion: CTS was fairly common among the rheumatology patients and diabetes patients were predominantly affected.
ORIGINAL RESEARCH ARTICLE | March 16, 2022
Domestic Accidents in Children Under 15 Years of Age in Kinshasa: About 80 Cases at the Pediatric Hospital of Kalembe-Lembe between 2019 and 2020
Atuba Mamenepi Pascal, Mokili Sambwa Yves, Andjelani Ngongo Angel, Mangbala Ekiebe Didier, Lofandjola Masumbuku Jacques, Panda Lukongo Kitronza Jean Paul, Tshimungu Kandolo Félicien
Page no 141-147
Context: Children are vulnerable people who in most cases are exposed to domestic accidents. These accidents occur most frequently in children under 15 years of age. Purpose: The purpose of this study was to describe the characteristics of domestic accidents in children under 15 years of age hospitalized in Kinshasa. Methods: A retrospective descriptive study was conducted in Kinshasa among 80 children who were victims of domestic accidents between 2019 and 2020. A document analysis tool was used to collect data. Results: These domestic accidents affected more children under 5 years of age (median = 3.5) with a sex ratio of 1.3. They are mainly burning (38.8%) with boiling water as the origin (64.5%) as well as trauma (37.5%) following a fall (86.6%). They occurred more during the day (56.3%), in the playground (47.5%), or in the kitchen (32.5%). These accidents affected the head (35%) and the limbs. Wounds (42.5%) were the dominant type of injury, followed by fractures (32.5%). 81.2% of accidents were managed by health personnel and 40% left lameness consequently. Conclusion: Domestic accidents are common in Kinshasa. Raising the awareness of mothers and those in charge of their care would contribute effectively to their reduction or better prevention. These results constitute a basis for the development of a policy aimed at reducing these accidents.
ORIGINAL RESEARCH ARTICLE | March 22, 2022
Psoriasis Vrs Cassia Fistula: In-Silico Study
Mr. Chandra Sekhar Tripathy, Dr. Anil Kumar, Prof. Ghassem Habibi Bibalani, Dr. Santosh Kumar Behera, Santanu Kumar Budhia, Dr. P K Mohanta, Easter Khura, Dr. Asadollah Asadi, Dr. Arash Abdolmaleki, Prof. Muhammad Akram, Dr. Debasish Mishra, Deepak Bhattacharya
Page no 148-158
Psoriasis is a skin disease. It is rare growing disease around the world. Here in this investigation we have targeted a protein namely TRPV3 (Transient receptor potential cation channel, subfamily III) ion channel for the study of psoriasis, which is important factor of psoriasis. The medicinal plant namely Cassia fistula is selected for the in silico investigation. 39 phyto compounds as reported in various research papers are taken for study. Out of 39 phytochemicals, Chrysophanol compound showed highest binding affinity of -7.58kcal/mol having 3 conventional Hydrogen bonds with TRPV3 protein and is found to be a better natural compound as compared to other reported drugs generally used to for the psoriasis. This investigation will lead to more and better findings leading to drug discovery & use as functional food.
ORIGINAL RESEARCH ARTICLE | March 25, 2022
Role of C - Reactive Protein as an Inflammatory Marker in Patients with Coronary Artery Disease: A Case – Control Study in Erbil- Kurdistan Region of Iraq
Dr. Shwan Othman Amen
Page no 159-167
Background and aim: Inflammation has been long regarded as a key contributor to atherosclerosis. Recent decades have provided extensive and mounting evidence concerning the pivotal interplay between inflammation and CAD, reinforcing the concept of inflammation not only as a risk marker but also as a risk factor for the development and progression of atherosclerotic disease. Methods: This was a case control study that has been enrolled among 404 patients, divided into two different groups (case-CAD patients and control group-Patients with Normal Coronary Angiography) that presented to Catheterization unit of Surgical Specialty Hospital- Cardiac Center/ Erbil City-Iraq from 1 Sept 2021 to 1 Jan 2022. Results: A total of 404 patients of case and control group was included from both genders, the mean age was 55.9 ±10.6, ranging from 30 to 77 years of age, based on their coronary angiographic profile 57.4% of them were Coronary Artery Disease cases and 42.6% were controls. (58.4%) of the study population were males and (41.6%) were females. The mean of CRP level amongst cases were higher (6.2 ± 10) than the controls (3.5 ± 4.7), and this was significant with a P = 0.022. In our study we found that Highly Sensitive-CRP was high amongst Case Group (Patients with CAD) by 70% while comparing to only 30% of Control group who had High CRP levels. And this was statistically significant with a P value of 0.003. Conclusion: The level of CRP was higher among patients with Coronary Artery Disease, than those with Normal Coronary Angiography. The level was higher among.
ORIGINAL RESEARCH ARTICLE | March 28, 2022
Correlation of Serum S-100 Protein Level with Severity of Ischaemic Stroke
Dr. Shagufta Mehzabeen, Prof. Md. Quddusur Rahman, Dr. Md. Shahidullah Sabuj, Prof. Debatosh Paul, Dr. Sheuly Ferdousi, Dr. Md. Abdul Kadir Shahin, Dr. Md. Shahariar Zaman
Page no 168-174
Background: Stroke is currently the second leading cause of death worldwide and the first leading cause of death in Bangladesh. The National Institute of Health Stroke Scale is the most commonly used deficit rating scale to assess stroke severity. S-100 protein is a low molecular weight calcium-binding protein expressed mostly in glial cells like astrocytes, oligodendrocytes, and microglial cells. During the ischaemic process, S-100 protein is secreted from the glial cells into the extracellular space. After secretion, S-100 protein releases initially into the cerebrospinal fluid and then eventually into the bloodstream due to disruption of the blood-brain barrier. Aim of the study: To correlate serum S-100 protein level with the severity of ischaemic stroke. Methods: This cross-sectional study was conducted at the Department of Laboratory Medicine in collaboration with the Department of Neurology, BSMMU, Dhaka, Bangladesh from September 2018 to August 2019. A total of 70 ischaemic stroke patients were enrolled in this study. After taking proper history and neurological examination, the severity of ischemic stroke was assessed on the basis of NIHSS score. Then, serum S-100 protein levels were measured by the Electrochemiluminescence Immunoassay method. Statistical analysis was done by SPSS version 22.0. Results: According to the NIHSS scores, 35(50.0%) of the patients had moderate stroke (NIHSS score=5-15), 17(24.3%) had minor stroke (NIHSS=1-4), 12(17.1%) had moderate to severe stroke (NIHSS=16-20) and 4(5.0%) had severe stroke (NIHSS=21-42). The mean S-100 protein level was found 0.283±0.165 μg/L. Mean S-100 protein levels was assessed in different categories of severity of ischaemic stroke. Maximum Mean± SD value of serum S-100 protein was found in case of severe stroke (NIHSS score=21-42; Mean ± SD: 0.739±0.207, range: 0.523-1.019). The significance test was done by ANOVA test which was found statistically significant (p-value <0.001). Pearson’s correlation test revealed a significant strong positive correlation (r=+943, p<0.001) between serum S-100 protein level and NIHSS scores of ischaemic stroke patients. Conclusion: In the present study it was found that serum S-100 protein levels were higher in severe ischaemic stroke in relation to the ischaemic stroke of lower severity. S-100 protein level is rapidly determined by the method used in the present study. Serum S-100 protein level in this regard can be used as an important tool to predict the severity of ischaemic stroke. Further study is needed to confirm the findings of the present study.
ORIGINAL RESEARCH ARTICLE | March 30, 2022
Laparoscopic Management of Hepatic Hydatid Cyst at Bangabandhu Sheikh Mujib Medical University
Dr. Md. Abul Kalam Chowdhury, Dr. Md. Rassell, Dr. Nusrat Ara Yousuf, Saif Uddin Ahmed, AHM Towhidul Alam
Page no 175-180
Background: Laparoscopic management of hydatid cyst in the liver is now becoming popular with the introduction of modern devices like Pallanivelue Hydatid Cyst Cannula System that makes the procedure easier, safe, and acceptable. The laparoscopic approach is not only a cosmetic issue; it also prevents the recurrence rate by preventing spillage and complete removal of endocyst. Objective: Here we assess the Laparoscopic management of hydatid cyst in the liver of 30 cases at the Department of General Surgery. Methods: It is a prospective study having ages ranging from 18 to 65 years were included in this study, from April 2015 to March 2020. Laparoscopic endocystectomy was performed in all cases with deroofing of the cyst wall and observed the outcome of the procedure. All the cases were diagnosed clinically and confirmed by ultrasonography and CT scan. Results: A total of 30 patients, 13 males, and 17 were females. The most common presenting complaints were pain in the abdomen in 20(66.66 %), a lump in the right upper abdomen in 18(60 %), jaundice 2(10 %). Hepatic Hydatid cyst diagnosed by USG, CT scan, and serological test were included in this study. The distribution of cyst sizes was: 1-5 cm 3; 6-10 cm 8; 11-15 cm 10; > 15 cm 9 patients. Abdominal ultrasound and CT scan were done to confirm the diagnosis of hepatic hydatid cyst in all patients. The right lobe was involved in 25(83.33 %), left lobe in 4(13.33 %) with both lobes in 1(3.33 %). Intraoperative complications 5(16.66%). Per operative bleeding 1(3.33%), spillage 2(6.66%), and cystic biliary communication 2(6.66%). The main operating time was 95(60-120) minutes. The mean duration of hospital stay was 5.22(3-10) days. Conclusion: The laparoscopic cyst evacuation and omentoplasty using PHS are safe for treating the hydatid cyst of the liver in the selected patients, while addressing all the conventional surgical principles of treating the hydatid cysts, like aspiration, prevention of spillage, sterilization of cysts, and partial deroofing. It aids early recovery with good cosmetic results. PHS is an ideal method for single or multiple hydatid cysts of the liver with minimal complications and morbidity.