Evaluation of Serum Calcium Level Measurement in Total Thyroidectomy Patients - A Prospective Study in Tertiary Hospitals.

Postoperative hypocalcemia is the most frequent and common complication after total thyroidectomy. It is necessary to diagnose hypocalcemia immediately after total thyroidectomy for minimizing complications. The objective of this study was to measure and to evaluate the serum calcium level in total thyroidectomy patients. This prospective observational study was carried out in the Department of Clinical Pathology in collaboration with Department of Surgery & Department of Otolaryngology of BSMMU and Department of Otolaryngology of DMCH, Dhaka, during the period of September 2010 to August 2011. Total 65 patients were enrolled those came for total thyroidectomy irrespective of age and sex. Hypocalcemia was found in 25 cases and normocalcemia was found in 40 cases. Male were 16.0% and female were 84.0%. Females were predominant. The incidence of hypocalcemia was 38.5%. Asymptomatic hypocalcemia was found in 22 and symptomatic hypocalcemia was found in 3 cases. Hypocalcemia was developed mostly in malignant thyroid diseases. The mean difference of intraoperative (20 minutes after total thyroidectomy), after 24 hours and after 48 hours calcium levels were statistically significant (p<0.05) between patient with hypocalcemia and patient with normocalcemia in unpaired t-test. Serum calcium level significantly decreased after total thyroidectomy and most critical time is first 24 hours of post-thyroidectomy period. If clinical sign symptoms of hypocalcemia are not developed in this period, patient is safe and can be discharged from hospital.

Immunofluorescent microscopic findings in glomerulonephritis.

Histopathology and direct immunofluorescence (DIF) microscopy were performed on renal biopsy specimens of 60 clinically suspected cases of glomerulonephritis (GN). Histopathological diagnosis was obtained in 44 (73.3%) cases and immune complex deposition were detected by DIF in 28 (46.7%) cases. Immune complex deposition were observed in all cases of membranous GN, systemic lupus erythematosus (SLE), and rapidly progressive GN (RPGN), most of the cases of diffuse proliferative GN (2 out of 3) mesangioproliferative GN (12 out of 15) and focal glomeruloscleros is (3 out of 5 cases). No immune deposits were observed in minimal change GN, chronic GN, and diabetic nephropathy. Histopathological diagnosis was not obtained in 16 (26.7%) cases, 3 (5%) of which showed immune complex deposition by DIF. Anti-GBM nephritis was demonstrated in one (3.6%) case, the rest were immune complex nephritis.

Detection of early xerophthalmia by impression cytology and rose Bengal staining--a comparative study.

Twenty two cases were studied for early detection of Xerophthalmia by impression cytology and Rose Bengal staining. Patients were below 6 years of age and admitted in the paediatric ward of Dhaka Medical College Hospital. Assessment were done by conjunctival impression cytology and staining with 1% Rose Bengal dye. Estimation of serum retinol level was done by HPLC to correlate conjunctival findings with biochemical status. The mean age of the subjects were 3.15 +/- 1.75. Rose Bengal staining was positive in 40% cases and impression cytology was in 60% cases. The mean serum retinol level of the diseased children were 10.5 +/- 3. ug/dl. The sensitivity of Rose Bengal staining was 53.3% and that of impression cytology was 80% in detecting vitamin A deficiency when compared with serum retinol level. The specificity of Rose Bengal staining was 40% and that of impression cytology was 100%. Sensitivity of impression cytology was 100% in patient with retinol level 10 ug/dl.

Ewing's sarcoma of maxilla--a case report.

This paper reports the case of an adolescent girl who was admitted in the ENT ward, IPGMR in February '88 with the complaints of nasal obstruction, nasal discharge associated with progressive swelling of the right side of her face for 1 year. She had an operation at Chittagong Medical College Hospital 1 year back for some problem in the right side of the nose. No history of pain, nasal bleeding or visual disturbance were present. The nasal mass was mobile, insensitive and did not bleed on touch, but the facial swelling was red, soft and cystic. Clinically diagnosed as an Antral growth with Ethmoidal involvement. Radiologically revealed soft tissue swelling, obliteration of nasal fossa and opacification of sinuses. After surgical resection the facial mass was diagnosed as Ewing's sarcoma histopathologically. The patient needed radiotherapy but did not follow it.