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.

Articulation of speech of patients treated with radicular attachment assisted obturator following maxillectomy.

Background: Obturators are used to separate the oro-nasal opening. These improve speech and other oral functions as well as provide psychological support to the patients. Adding radicular attachments in an obturator makes more effective. Objective: To evaluate and compare the effectiveness of obturator with radicular attachment and conventional obturator in articulation of speech. Materials and Methods: Fifty patients, age ranged from 18 to 72 years, with maxillectomy defect were selected as the sample of the study. Among them 25 patients were treated with obturator with radicular attachment and another 25 patients were treated with conventional obturator. After insertion of obturator, data were collected on the basis of articulation of speech. Results: Patients treated with obturator with radicular attachment showed significantly better (P value <0.001) articulation of speech. Conclusion: Obturator with radicular attachment is more effective than conventional obturator.

Apexification with the use of calcium hydroxide.

After traumatic injuries the pulps of young permanent teeth often necrose. This occurs most commonly in the permanent maxillary incisors leaving the teeth with incomplete radicular development and open apices. In these cases treatment is aimed at promoting complete apical closure. At a later date a complete filling of the root canal is carried out in order to prevent inflammatory stimulators affecting the periapex. Apexification is a method of treatment intended to induce formation of a calcific barrier in an immaturely developed or pulpless tooth. The intent of apexification is to attain narrowing of the canal or closure of the apex. Apexification is indicated in young patients, for reasons such as trauma, fracture or caries involving the pulp require root canal treatment prior to the apex fully developing and closing.

Childhood acute poisoning in a tertiary medical college hospital of Bangladesh.

A total of 193(4.7%) cases of acute childhood poisoning admitted to paediatric Unit of Khulna Medical College Hospital, Bangladesh over a period of two years were studied to see the age and sex distribution, ingredients used, seasonal variation etc. Out of them 107(55.4%) cases were male and rest 86(44.6%) were female. 01-03 years was the most vulnerable age group to be affected. Kerosene was the commonest form of ingredient to be used. Overall mortality rate was 4.66%. Childhood poisoning was a common Medical emergency with considerable morbidity and mortality. Parents should be educated to keep the kerosene out of reach of the children. So, that mortality and morbidity can be reduced to a great extent.

Phytochemical and biological investigations of erythrina variegata

Five compounds were isolated from the n-hexane and chloroform soluble fractions of a methanol extract of the stem bark of Erythrina variegata. The structures of the isolated compounds were elucidated as alpinum isoflavone [1], epilupeol [2], 6-hydroxygenistein [3], 3beta 28-dihydroxyolean-12-ene [4] and stigmasterol [5] by extensive spectroscopic studies, including high field NMR analyses. Different partitionates of the methanol extract exhibited mild to moderate antimicrobial activity and varying degrees of cytotoxicity. Although, alpinum isoflavone [1] has previously been reported from E. variegata, this is the first report of isolation of compounds 2-4 and stigmasterol from this plant species

Rationality of drug uses: its Bangladeshi perspectives.

This review article was made on the basis of different articles, government & non- government documents. Clinically inappropriate & inefficient use of medicine is a very serious problem. It is estimated that more than half off medicines are inappropriately prescribed, dispensed or sold. Lack of access to medicines and inappropriate dose result in serious morbidity & mortality. WHO provided adequate guidelines for formulation of national use of drugs by every nation. Accordingly, Bangladesh still trying to achieve the standard, even with all hindrance. Government has given emphases on price, quality, safety, efficacy & access to drugs. Some new drugs are always introducing again some drugs are withdrawing such as rofecoxib. Monitoring use of medicines, a mandated multidisciplinary activities and sufficient government funding is critical to success.

Presence of neutral fat in stool and its association with aetiology and presenting features of diarrhoea in children.

Enteric infections, impaired digestion, loss of villous cells, and poor absorption of fat may lead to presence of neutral fat in stool, particularly in children with diarrhoea. We aimed to examine the association between presence of neutral fat in stool and aetiology of diarrhoea and nutritional status of the patients at different age groups. A total of 13,171 patients aged 5 days-106 years enrolled in the Diarrhoeal Disease Surveillance System of the Dhaka Hospital of ICDDR,B during 1996-2001 were studied. Presence of neutral fat in faecal specimens, aetiology of diarrhoea, and nutritional status in children below 5 years of age were determined and analysed. Of the total study individuals, 7,671 (58%) had neutral fat in their faecal specimens. Neutral fat was more frequently present in faeces of individuals infected with rotavirus in all age groups or in enterotoxigenic E. coli (ETEC) infection in children 0-23 months old while compared with those who did not have these infections (p=0.005, p=0.014, respectively). Neutral fat was less frequently (p<0.001) present in malnourished 0-23 months old children. Presence of neutral fat in the stool in diarrhoea due to rotavirus and in young childhood ETEC diarrhoea signifies compromised gastrointestinal function due to these infections. The mechanism of persistence of neutral fat in the stool of such patients, and its nutritional and clinical implications require further studies.

Treatment of non union of humerus using G. A. Ilizarov technique.

The management of the non union of humerus is one of the most challenging problems that the surgeon confronts in his practice. The procedures traditionally used are: I.M. Nailing, interlocking, plating, transplantation of allograft. In our series, 36 cases with non union has been treated by G.A. Ilizarov technique. The age range were: 21-62 years with an average of 32 years. The initial treatment were done by DCP, rush nails & plates with screw fixation. The duration of treatment ranged from 5-11 months (average 8 months). With the application of Ilizarov fixator a good range of elbow & shoulder motion were achieved. The average follow up period was 5 years with a range of 1-8 years. Union was achieved in all the 36 cases.

Study on Mycobacterium tuberculosis: the primary drug resistance pattern.

The study was carried out to investigate the primary drug resistance pattern of tubercle bacilli isolated from the pulmonary tuberculosis patient attended in Shyamoli TB clinic, Dhaka. Sputum from 961 suspected tuberculous patients were randomly collected and stained by Ziehl-Neelsen (Z.N) stain. 135 were microscopically positive for Acid Fast Bacilli (AFB). Among them 30 patients were excluded from the study as they received antitubercular treatment before. So only 105 microscopically positive cases were cultured on Lowenstein-Jensen (L-J) media and 100 showed pure growth and rest 5 were contaminated with fungus. These 100 cases were studied on 4 antitubercular drugs. Out of these 100 isolates, 91 were M. tuberculosis and rest 9 in the nonchromogen group of mycobacteria other than tuberculosis (MOTT) species. Among 91 M. tuberculosis species, 89 (97.80%) to Isoniazid (INH), 73 (80.21%) to Rifampicin (RMP) and 91 (100%) to Streptomycin (SM) and Ethambutol (ETHM) were sensitive. Of the 9 MOTT species, 4 (44.44%) to SM, 7 (77.78%) to ETHM were sensitive and all (100%) were resistant to INH and RMP. Among the 100 isolates, 27 (18 M. tuberculosis and 9 MOTT) were resistant to 4 drugs either single or in combination. Of the 18 (66.67%) M. tuberculosis species, 16 (59.26%) to RMP, and 2 (7.41%) to RMP and INH were resistant. Of the 9 (33.33%) MOTT species, 4 (14.81%) to RMP and INH, 3 (11.11%) to RMP, INH and SM and 2 (7.41%) to RMP, INH, SM and ETHM were resistant.

The transformation in vitro of peripheral lymphocytes of malnourished children.

Children with protein energy malnutrition showed high deranged cellular immunity as evidenced by impairment of lymphocyte transformation after stimulation by phytohaemagglutination (PHA). The proliferative response (PR) to PHA measured by estimating incorporation of tritiated thymidine into newly synthesized DNA. In-vitro proliferative response to PHA was used as a marker for studying the functional characteristics of T lymphocytes of children with different categories of malnutrition. PHA response of peripheral blood lymphocytes obtained from different categories of severely malnourished children were significantly low compared to healthy control children (P < 0.01). The results indicate that cell mediated immunity was grossly depressed in severe malnutrition.