Measurement of Popliteal Artery Diameter: A Cadavaric Study

The popliteal artery is the branches off from the femoral artery. It is located in the knee towards the back of the legs. The clinicians and radiologists dealing with the popliteal area use description of branching pattern of the popliteal artery, in which it first gives rise to anterior tibial artery followed by the tibial peroneal trunk, which then terminates by dividing into the posterior tibial and peroneal arteries. As popliteal artery is one of the most common sites for aneurysm formation, the knowledge of the normal popliteal artery diameter is essential to determine the relevance of popliteal dilatations. Objective: Considering the clinical importance of diameter of popliteal artery, this study was undertaken to note the internal diameter of popliteal artery. Subjects and Methods: The present study was conducted on 50 specimen embedded in 10% formalin from the department of Anatomy of tertiary care hospital & medical college. Cadavers which had gross pathological deformities in its lower limbs were excluded from the study. All the cadavers were adult males and females. Results: This study states right popliteal arteries are slightly larger (4.9 ± 0.7 mm) as compare to left popliteal artery (4.8± 0.5 mm). This study also reconfirm popliteal arteries of men are slightly larger than that of female (4.9 ± 0.7 mm), (4.6± 0.9 mm) and left popliteal artery (4.8± 0.5 mm), (4.6± 0.7 mm) respectively. On the other hand terminal part its diameter is slightly larger in male (4.5 ± 0.6 mm) as compare to female (4.3 ± 0.5 mm). This study also shows terminal end of left popliteal arteries (3.8 ± 0.7 mm) are smaller than right popliteal arteries (4.3 ± 0.5 mm). Conclusion: The present study was done in a small cadaveric sample. In our prospective different live and cadaveric study will be helpful for vascular surgeons, radiologists. The variation in the measurement of our study compare to other study may be due to the difference in live and cadaveric spacemen or due to the method of measurement. Therefore, we suggest before making any decision study on much larger sample should be consider

New Cholesterol Management Guideline 2013: A Review.

Management of high blood cholesterol is the key point for the treatment and prevention of Atherosclerotic Cardiovascular Disease (ASCVD). Till 2013, Adult Treatment Panel III (ATP III) report was the guideline for the physician for blood cholesterol management. The main feature of this guideline was to achieve a particular target cholesterol level by lifestyle modification, dietary changes and lipid-lowering drugs. But the recently released American College of Cardiology (ACC) and American Heart Association (AHA) guidelines shifted attention to Statin use at high-, moderate- or low-intensity instead of chasing a cholesterol goal. This article reviews the main features of this new guideline comparing to the previous one, where appropriate.

A Study of Snake Bite Cases in Faridpur Medical College Hospital, Faridpur.

Snakebite is one of the important cause of mortality in our country. This study was carried out to see the common type of snakes in local area with clinical presentations, complications and outcome of snake bite patients inFaridpur. Fifty cases of snakebite patients in medicine wards of Faridpur Medical College Hospital from 1st January 2012 to 31th April 2013 were studied. Among 50 snake bite patients 35 (70%) were male and 15 (30%) were female. Among them 30 (60%) were venomous and 20 (40%) snake bite cases were non-venomous.The common victims were farmers (53%) and housewives (13%). The bites were commonly encountered during rural foot walking (32%) followed by sleeping (15%). 55% were bitten during outdoor and agriculture related activities. 65% had sustained bite in lower limbs. The majority (82%) of the snakebites were observed during the month. Total 98% patients applied multiple tight tourniquets in the affected limb. A common local practice (seen in 85%) was to receive pre hospital treatment from 'Ohzas'. Among 30 poisonous cases, drooping of the upper eyelid, external ophthalmoplegia and brocken neck were the common features of poisoning. Among the 30 venomous snake bite cases 21 (70%) recovered completely after getting polyvalent antivenom serum and 9 (30%) died after admission. Total 80% cases recovered with 10 vials of polyvalent antivenom serum but others required upto 30 vials depending on severity of symptoms and its duration. No reaction to anti-snake venom was noticed.

Treating Asthma in Pregnancy - An Update.

Asthma is one of the most common chronic medical conditions affecting the lungs during pregnancy. At any given time, up to 8% pregnant women have asthma. During pregnancy, asthma not only affects the woman, but it can also cut back on the oxygen to fetus. But this does not mean that having asthma will make pregnancy more difficult or dangerous to fetus. Pregnant women who have asthma that is properly controlled generally have normal pregnancies with little or no increased risk to pregnant women or their developing babies. Currently available national guidelines for the treatment of asthma during pregnancy emphasize the objective measurement of control, patient education, motivation, caution and medication adherence. The article reviews the available literature highlighting the appropriate selection of medications in the treatment of asthma during pregnancy, and to identify those factors which may influence the asthma care provider's ability to successfully manage this condition, and also illustrate that maintaining asthma control with long term medications in pregnancy is safer than the risk of uncontrolled asthma or untreated exacerbations for both the mother and the fetus. Women's drug treatment during pregnancy should be regularly assessed in the light of asthma control criteria.

Management of Inflammation in Chronic Obstructive Pulmonary Disease-Update.

Chronic obstructive pulmonary disease (COPD) is a systemic inflammatory condition, the earliest manifestation of which is airway obstruction which is only partially reversible and the treatment rationales are provided accordingly. Research has shown that COPD-inflammation involves multiple inflammatory cells and mediators and the underlying pathology differs from asthma inflammation.For these reasons, therapeutic agents that are effective in asthma patients may not be optimal in COPD patients. COPD exacerbations are intensified inflammatory events compared with stable COPD. The clinical and systemic consequences believed to result from the chronic inflammation observed in COPD, suggest that inflammation intensity is a key factor in COPD and exacerbation severity and frequency. Although inhaled corticosteroids are commonly used and are essential in asthma management, their efficacy in COPD is limited, with only a modest effect at reducing exacerbations. The importance of inflammation in COPD needs to be better understood by clinicians, and the differences in inflammation in COPD versus asthma should be considered carefully to optimize the use of anti-inflammatory agents. Current COPD management focuses predominantly on symptom relief by optimizing bronchodilatation. The role of phosphodiesterase type 4 inhibitors (PDE4), statins, angiotensin converting enzyme inhibitors, theophylline and tumor necrosis factor inhibitors in COPD management will be reviewed. Targeting COPD inflammation with the goal of reducing exacerbations is a major focus of current clinical practice & outcome research.

Outcome of Upper Gastro Intestinal Haemorrhage - a Hospital Based Prospective Study.

Upper GI bleeding is a common medical emergency with a significant mortality, outcome of which depends upon the cause, appropriate and early intervention in a specialized center. This study was carried out to see the outcome of patient with Upper GI haemorrhage. Fifty cases with episode of upper gastrointestinal haemorrhage, admitted into medicine units of Faridpur Medical College Hospital from January 2011 to December 2011, were studied. Duodenal ulcer was the commonest cause of haematemesis and melaena followed by oesophageal varices, gastric ulcer and erosive gastritis. The peak incidence was among 35 to 45 years of age. Over all male female ratio was 4.55:1 but in case of duodenal ulcer it was 9:1. During hospital stay recurrent bleeding was noted in 10% of patients and during subsequent follow up it was 10% of the total and 50% in case of variceal bleeding group. Over all hospital mortality was 4% .

Silicosis - A Case Report.

Silicosis is not an uncommon disease in Bangladesh as a good number of people are exposed to silica dust in their working places. Again pulmonary tuberculosis is also common here, the risk of which is increased by about 30 folds in silicosis. In the reported case, a young stone cutter of 40 years was admitted to Faridpur Medical College Hospital with progressive dyspnoea, dry cough and radiological appearance of multiple small and a large nodular pulmonary mass. Two of his brothers, also stonecutter, died of similar disease. In this context the patient was diagnosed as a case of chronic complicated silicosis and treated symptomatically as there is no curative treatment. A good number of people are engaged in stone cutting in our country including Faridpur district and are vulnerable to this progressive and non-curable disease. To aim of this case report is to make those people to be aware about the condition, so that they can protect themselves by taking appropriate measures (i.e. using protective mask) and should monitored their condition by regular chest x-ray. If early signs of silicosis is detected the worker should changed their job.

Profile Of Clinically Suspected Encephalitis Patients Admitted To Faridpur Medical College Hospital, Bangladesh.

Encephalitis is a relatively common clinical diagnosis of admitted patients in Faridpur Medical College Hospital. This is significant because there was an outbreak of Nipah Virus (Ni-V) encephalitis in Faridpur district in 2004 with 34 cases including 26 deaths. Recent death of an intern doctor of FMCH from Ni-V encephalitis further emphasizes the gravity of situation. In this study a total number of 100 cases of clinically suspected encephalitis patients were studied for different clinical parameters. This is a retrospective study using data from hospital records. Majority of patients presented with neurological features (85%), 6% with pulmonary, 7% with combined neurological and pulmonary, and 2% with other features. 5-18 years age group comprises the highest number 44%, followed by >18 years age group 34%. Male-female ratio was 33:17. July to November was the period of maximum number of admission, the highest being in August. Patient from all upazillas of Faridpur were admitted, the highest being from Sadar Upazilla. 48% of the patients recovered, 19% expired and 7% were referred. In this context, further prospective study is urgently required to find out the epidemiological characteristics of Nipah virus encephalitis in Faridpur region.

Aetiology Of Pyrexia With Hepatosplenomegaly: Study Of 50 Cases In MMCH (Bangladesh).

Pyrexia with hepatosplenomegaly is a common problem in medical practice globally, specially in tropical countries. In Bangladesh several tropical diseases as well as hematological malignancies are responsible for such clinical syndrome. Again different tropical diseases vary in endemicity in different regions in Bangladesh. In Present study 50 hospitalized cases of pyrexia with hepatosplenomegaly of 15-50 years of age are included from 01.01.2002 to 30.06.2002 in MMCH to find out their aetiologies. Fever with only hepatomegaly, or with only splenomegaly or hepatosplenomegaly without fever was not included in this study. Duration of fever was two weeks to three months. 35(70%) cases were male and 15(30%) were female. 27(54%) cases were visceral leishmaniasis (kala-azar), 8 (16%) malaria, 6 (12%) Acute leukemia (ALL, AML), 3 (6%) Lymphoma, 3(6%) Enteric fever, 2(4%) CML, 1(2%) Disseminated TB. Although kala-azar and malaria are tow common causes of fever with hepatosplenomegaly, haematological malignancies and tuberculosis should be in mind.