Negative PressureWound Therapy (NPWT) in open wound management: A study of 16 Cases in Orthopaedic Department of Faridpur Medical College Hospital.

Wound management is a major concern in open fracture cases. Negative Pressure Wound Therapy (NPWT) is an advanced method for managing open wounds. It is a topical treatment using sub-atmospheric pressure to increase blood flow, remove bacteria and increase growth of granulation tissue in the wound. The study was performed to evaluate the results of NPWT in patients with open fracture in lower extremity. Using Aquarium pump as an NPWT device, 16 patients were prospectly treated for open fractures in their inferior extremity. Mean patients' age range was 21 to 60 yrs. The patients under study either had suffered from trauma, fall or had post operative wound infection. Many of them had wounds with underlying tendon or bone exposure. Necrotic tissues were debrided before applying NPWT. Dressings were changed every 3rd or 4th day and treatments were continued for 07 to 28 days. Exposed tendons and bones were successfully covered with healthy granulation tissue in all cases, depth of the wounds reduced as well as surface areas. In 12 cases coverage of granulation tissue were achieved and further managed by skin grafting, 4 cases with wound infections were closed with secondary suture. No significant complications were noted regarding the treatment. NPWT was found to facilitate the rapid formation of healthy granulation tissue on open wounds in lower extremity and thus to shorten healing time and minimize secondary soft tissue defect coverage procedures.

Serum calcium and phosphate level in normal pregnant women.

Background and Objectives: Pregnancy is the physiological process in which progressive anatomical, physiological and biochemical changes occur. Secretion of different hormones during pregnancy is responsible for maternal adaptation to the increasing demand of the growing fetus. The present study was aimed to evaluate serum calcium and phosphate status in normal pregnant women in different trimesters. Materials and Methods: A total number of 140 subjects, age range 20-40 (yrs) were recruited in the study which includes 100 normal pregnant women termed as study group (Group B) and 40 healthy women without pregnant (Group A), served as Control. Group B subjects were subdivided into Group B1 (n=12), Group B2 (n=30) and Group B3 (n=58) on the basis of duration of pregnancy- 1st, 2nd and 3rd trimesters respectively. Calcium was measured by CPC (photometric method for Ca) and serum phosphate by colorimetric method. Statistical analysis was done using SPSS for Windows, Version 10. Unpaired Student's -'t' test performed to calculate statistical differences between groups. Results: Age (yrs) (mean±SD) and BMI of the pregnant women in different groups did not show statistical difference. Serum calcium (mean±SD) levels in the 1st (p=0.0001) and 2nd (p=0.02) trimester was significantly higher compared to the Controls. In 3rd the value was significantly lower (p=0.015) compared to the Controls and of 1st and 2nd trimesters (p=0.001). Serum phosphate (mean±SD) levels in three trimesters did not show statistical significant difference compared to the Controls and among the pregnancy groups. Conclusion: The data concluded that serum calcium level was lower during third trimester of the study subjects which may be explained by the fact of increased demand of the growing fetus and exposing the mother at risk of complications related to low serum calcium.

Study of 89 Cases of Peripheral Vascular Disease by CT Angiography.

Objective: The purpose of this study was to observe the morphological pattern by CT angiography and risk factors for development of peripheral vascular disease in Bangladeshi patient suffering from peripheral vascular disease using a multidetector scanner in the evaluation of patients with peripheral vascular disease. Subject and Method: Eighty nine patients with peripheral vascular disease who were referred for evaluation of peripheral vascular disease underwent CT angiography. We scanned patients from the level of the cerebral arteries to the pedal arteries in a single helical scan. CT angiograms were produced using maximum-intensity-projection, multiplanous reformation and reconstructions. Findings were graded according to nine categories: 1, normal (0% stenosis); 2, mild (1-49% stenosis); 3, moderate (50-74% stenosis); 4, severe (>75% stenosis); 5, tortuosity; 6, aneurysm, 7, calcification, 8, Arteriovenous malformation (AVM), and 9, haematoma. Results: We found Most of the patients in our study were male (69 out of 89 patients). The mean age was 54.49 ±18.36 in male and 49.45 ±17.89 for female. Commonest risk factor in our study was hypertension 46.1%, followed by diabetes 30.3%, family history 27% smoking 23.6%, dyslipidaemia13.5%. Stenosis (5.61%) was the predominate lesion followed by haematoma (4.49%), Arterio –venous malformation (4.49%). Abdominal aorta was mostly affected in the studied population (58.43%) followed by Lower limb (37.08%), Carotid (22.47%), Renal (7.87%) and Upper limb arteries (4.49%). Conclusion: CT angiography is a noninvasive technique for the imaging of peripheral vascular disease. Since no data is available from a well designed study in PVD in our country, till then the data obtained from this study can be used in Bangladesh.

Extent of Mesoappendix of Vermiform Appendix in Bangladeshi People.

Background: The mesentery of the appendix extends almost to the appendicular tip along the whole tube or may not be to the tip. The mesoappendix has a free border which carries the blood supply to the organ. Failure of the mesoappendix to reach the tip probably reduces the vascularization of the tip of the organ making it more liable to become gangrenous and hence early perforation occurs during inflammation. Objective: This cross sectional study was carried out to advance our knowledge regarding the extent of mesoappendix in Bangladeshi people and also to find out the variations in the anatomical positions of the vermiform appendix in Bangladeshi population and their distribution according to the sex. Methods: A total of 100 (60 male and 40 female) specimens of vermiform appendix were collected of different age and sex during postmortem examination in the morgue of Mymensingh Medical College from July 2006 to June 2007. Data was collected by convenient sampling technique. Results: In this study pelvic position of the vermiform appendix were common in both sexes. The two thirds extension of mesoappendix was found in 45% cases where as in pelvic position it was 26 (14 male and 12 female) cases. Half and whole extension of mesoappendix were found in 31% and 24% cases respectively. Among half extension of mesoappendix, retrocaecal position were found to be more (12) than other positions. In whole extension of vermiform appendix pelvic position were found to be common (16) than others. Conclusion: This study provides certain basic information of extent of mesoappendix of vermiform appendix of Bangladeshi population which is responsible for vascularization of the organ and severity during inflammation.

Antioxidant activities of dithiol alpha-lipoic acid.

Alpha-lipoic acid, a dithiol compound derived from octanoic acid, which acts as a coenzyme for several redox reactions in almost all the tissue of the body. It retains its protective functions in both oxidized and reduced forms. Alpha-lipoic acid reduces oxidative stress by redox generation of other antioxidants such as vitamin C, E and increasing the intracellular glutathione. Exogenous alpha-lipoic acid has been shown to increase ATP production due to its role in the oxidation of pyruvate and alpha-ketoglutarate in the mitochondria. Alpha-lipoic acid administration has been shown to be effective in preventing pathology in various experimental models in which reactive oxygen species have been implicated.

Association between Morphological Changes of Nail and Nail Arsenic Level in Patients with Arsenicosis.

This case-control type of analytical study was conducted in the Department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh to find out the association between morphological changes of nail and nail arsenic level in arsenicosis patients. Majority of arsenicosis patients were male (56.67%). The mean age of the cases was 43.07+/-13.73 years. Nail changes were found in 26.67% of cases, most were nail dystrophy (23.33%) and rest were Mee's line (3.34%). There was significant difference between cases with or without nail changes and nail arsenic level. But cases with or with out nail changes had a significant difference between duration of intake of arsenic contaminated water. There was no correlation between nail changes and nail arsenic level for nail dystrophy and Mee's line. The study result failed to establish association between the morphological changes of nail and nail arsenic level.

Study of 89 Cases of Peripheral Vascular Disease by CT Angiography in a Centre of Bangladesh.

Background: The peripheral arterial disease generally refers to a disorder that obstructs the blood supply to upper and lower extremities, most commonly caused by atherosclerosis. Objective: The purpose of this study was to observe the morphological pattern and risk factors for development of peripheral vascular disease in Bangladeshi patients suffering from peripheral vascular disease by CT angiography using a multidetector scanner. Method: Eighty nine patients with peripheral vascular disease who were referred for evaluation of peripheral vascular disease underwent CT angiography. We scanned patients from the level of the cerebral arteries to the pedal arteries in a single helical scan. CT angiograms were produced using maximum-intensity-projection, multiplanous reformation and reconstructions. Findings were graded according to nine categories: 1, normal (0% stenosis); 2, mild (1-49% stenosis); 3, moderate (50-74% stenosis); 4, severe (>75% stenosis); 5, tortuosity; 6, aneurysm, 7, calcification, 8, Arteriovenous malformation (AVM), and 9, haematoma. Results: We found Most of the patients in our study were male (69 out of 89 patients). The mean age was 54.49 ±18.36 yrs in male and 49.45 ±17.89 yrs for female. Commonest risk factor in our study was hypertension 46.1%, followed by diabetes 30.3%, family history 27%, smoking 23.6%, dyslipidaemia13.5%. Stenosis (5.61%) was the predominate lesion followed by haematoma (4.49%) and arterio–venous malformation (4.49%). Abdominal aorta was mostly affected in the studied population (58.43%) followed by Lower limb (37.08%), Carotid (22.47%), Renal (7.87%) and Upper limb arteries (4.49%). Conclusion: CT angiography is a noninvasive technique for the imaging of peripheral vascular disease. Since no data is available from a well designed study in PVD in our country, till then the data obtained from this study can be used in Bangladesh.