Preoperative malignant looking retrobulbar, infratemporal and middle cranial fossa tuberculoma in a young child - a case report.

Tuberculosis involving skull base and brain is relatively common in developing countries. Preoperative neuro-radiological features of such lesions mimic neoplastic lesions of brain & skull base and postoperative histopathological study brings the ultimate diagnosis. Here we present a case of large tubercular lesion involving retrobulbar, infratemporal and middle cranial fossa that preoperatively thought to be a malignant lesion in a young child and was managed surgically with anti-tubercular drugs having a happy termination. Even radiologically malignant looking mass lesion in brain and skull base can be proved as tuberculosis that can bring happiness to the patient and also to the treating neurosurgeons.

Abundance of Road Traffic Accidents among Medicolegal Postmortem Cases..

This retrospective study was conducted at the Dhaka Medical College (DMC) morgue during the period of Jan 2008 to Dec 2008. The objective of this study was to find out the abundance of Road Traffic Accidents (RTA) cases among medicolegal post mortem examinations performed at DMC morgue and in this relation to evaluate the present situation of RTA in our country. It has been observed that RTA cases are the most common cases among various types of medicolegal post mortems. A total of 2714 postmortems were conducted during the study period and out of which 813 (29.95%) cases were of RTA, among the victims 545 (67.03%) were male and 268 (32.96%) were female. Highest incidence (30.38 %) of RTA was observed among the age group 21 to 30 yrs. Most accidents occurred at daytime 282 (34.68%), followed by night 233 (28.66%). Greater number of accidents occurred during September 90 (11.07%), followed by January 85 (10.45%) and December 83 (10.20%). Commonest victims were pedestrians 564 (69.37%). Most accidents took place on highways 650 (79.95%) and buses were the most dangerous vehicle causing highest number of accidents 307 (37.76%), followed by truck 141 (17.34%). Among the cases 100% victims had multiple abrasion and bruise, laceration were present in 654 (80.44%), and intra cranial injury 527 (64.82 %).

Prevalence Of Hematological Disorder: A Bone Marrow Study Of 177 Cases In A Private Hospital At Faridpur.

Bone marrow examination of 177 cases of suspected hematological disorders was carried out in a private hospital at Faridpur from May 2007 to August 2009. Among the malignant hematological disorders, Acute Myeloid Leukemia (AML) was the most common disorders (27.69%) followed by Acute Lymphoblastic Leukemia (9.04%), MDS (7.91%), CML (7.34%) and Multiple Myeloma (1.69%). Among the non-malignant hematological disorders, Combined (both iron and folic acid and /or Vitamin B12) deficiency anemia was the most common disorders (24.87%) followed by Aplastic anemia (10.74%), ITP (6.21%), and Kala-azar (2.82%).

Role of cardiac troponin I in staging and prognosis of congestive heart failure subjects.

Congestive heart failure is the one of the major cardiovascular disorder that is increasing in incidence and cause of death globally. Mortality rate has increased 40%-50% in advanced cardiac failure and 15%-25% in mild to moderate cardiac failure within one year of diagnosis. There is no established biochemical marker for the diagnosis, prognosis and staging of heart failure. Cardiac Troponin I may be a novel useful tool in identifying patients with Heart failure who are at increased risk for progressive ventricular dysfunction and death. Thirty six congestive heart failure cases and thirty six healthy controls were included in this study and serum cardiac troponin I and Ejection fraction were measured. All the study subjects were grouped according to the NYHA class they belong. Cardiac troponin I was significantly higher in CHF cases than the controls. Troponin I also significantly differed among groups. EF of cases was significantly lower than the controls and also differed among groups. A significant negative correlation between cardiac troponin I and progressive decline of ejection fraction was evident in this study. Cardiac troponin I increased progressively with progression of heart failure. Thus, Cardiac troponin I could be used to stratify patients undergoing heart failure in to high and low risk groups for future cardiac events. Cardiac troponin I could also be used as a very important marker for the prognosis of the patients with congestive heart failure.

Spot morning urine protein creatinine ratio and 24 hour urinary total protein excretion rate.

Proteinuria helps to establish the diagnosis of most renal diseases and also to predict the outcome of such diseases. Proteinuria is biochemically represented by measuring the protein concentration in timed collection of 24 hour urine. But, 24-hour timed urine collection is time consuming, cumbersome and often unreliable due to collection errors and also results in undue delay on diagnostic process. An alternate approach avoiding arduous and inaccurate timed urine collection can be the measurement of protein creatinine ratio in spot morning urine. This study was aimed to evaluate whether the spot morning urine protein creatinine ratio can be a reliable alternative to 24-hour urinary total protein (UTP) estimation. The study was carried out in the department of Biochemistry, Bangabandhu Sheikh Mujib Medical University, Dhaka on 50 (fifty) non-diabetic Chronic Renal Disease (CRD) patients with an age ranging from 18 -70 years. The study subjects were grouped into mild, moderate and severe CRD on the basis of GFR. Urinary protein and creatinine concentrations were measured in spot morning urine samples and their ratios were calculated. Urinary protein measured in 24-hour timed collected urine samples gave the 24-hour UTP excretion rate. In our study, spot morning urine protein creatinine ratio significantly correlated with 24-hour UTP excretion rate in all CRD patients. Severe CRD patients gave significant positive correlation (p<0.05), whereas mild and moderate CRD patients gave very highly significant positive correlation (p<0.001). Therefore, it may be suggested that protein creatinine ratio in spot morning urine can be accepted as a reliable and alternative to 24-hour UTP excretion rate in non-diabetic chronic renal disease patients. This simple and inexpensive procedure will thus simplify the way of establishing the severity of renal disease along with its prognosis.

Extracranial complications of chronic suppurative otitis media.

The aim of this study was to find out the pattern of extracranial complications of CSOM cases who attended to the department of ENTD, Mymensingh Medical College Hospital during the period from July'1999 to June' 2001. Different types of extracranial complications of CSOM were presented here. A total of 100 cases, diagnosed clinically and radiologically were included in the study of which 66 were male and 34 were female giving a male to female ratio of 1.94 : 1 (p < 0.05). Majority cases (53) were in the age group of 11- 20 years followed by the age group of below 10 years where there were 30 cases. Majority (64) cases came from low socio-economic class. The number of different types of extracranial complications of CSOM were as follows: mastoid abscess 57, discharging sinuses 28, purulent labyrinthitis 07, Bezold's abscess 04, fascial nerve paralysis 03 and zygomatic abscess 01. In all cases of CSOM Cholesteatoma were detected. In 14 cases, Cholesteatoma were associated with granulation tissue/polyp. Modified radical mastoidectomy were performed in all cases. On analyzing the findings of the present study it was observed that mastoid abscess were the predominant extracranial complications of CSOM, affecting mostly the male population of 11 - 20 years age group coming from low socio-economic class.

Outcome of patients treated with the endoscopic dacryocystorhinostomy.

DCR allows an abstracted lacrimal drainage system to be drained into the nasal fossa. Since the development of endonasal endoscopic surgical technique, the endonasal approach presents it self as an alternative choice to the conventional external approach as in the former skin scar can be avoided. We performed DCR of 50 cases in endonasal endoscopic approach in Mymensingh Medical Collage Hospital. The age range of patient was found between 7 to 35 years, average 21 & male female ratio was 1:1.5 with follow up to 2.10 years with high success rate. Associated nasal disease correction septoplasty was done in 7 cases. In each & every case silicon tube was introduced & removed after 3 to 6 months. The only complication was periorbital injury in 5 cases, punctal tear in 2 cases and granuloma formation in 2 cases. Overall success rate was 86%.

A study of functional endoscopic sinus surgery technique.

Endoscopic sinus surgery has become a widely accepted surgical procedure for the treatment of chronic inflammatory sinus diseases. In our study 100 patients were suffering from polyposis treated by functional endoscopic sinus surgery in MMCH. Out of 100 patients 53 patients were suffering from ethmoidal polyp and 47 patients were suffering from antrochoanal polyp between the ages 7 to 45 years. Among antrochoanal polyp 2 patients were found with inverted papilloma and came with recurrence. 40% of the patients came with a follow up visit up to 1 year. 7 out of 53 cases of ethmoidal patient came with recurrence requiring revision FESS. There was no history of patient suffering from asthma or aspirin intolerance. Overall success rate was observed in 91%. Four patients were found with periorbital haematoma and 5 with fat coming out from orbit due to injury of lamina papyraceae.