ABSTRACT
Background: Prolapsed lumbar intervertebral disc is one of the most common problems encountered in medical practice. In orthopaedic practice patients having lesions of lumbosacral region causing low back pain with sciatica are not uncommon since the begdatainning of recorded history. To evaluate the fenestration and discectomy for prolapsed lumbar intervertebral disc by minimally invasive procedure.Material & Methods:This prospective observational study was conducted at National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh during July 2015 to June 2017. A total of 31 patients with prolapsed lumbar intervertebral disc were included for the study. A 3cm incision was made in midline on back centering the desired space of the spine. The analysis was done according to the standard statistical analysis system. Prior to commencement of this study, the research protocol was approved by the Institutional Review Board of ethics of National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR).Results:Mean age was (35.98 ± 8.50) years with the range from 17 to 50 years. Out of 31 patients, 26 (83.87%) patients were male and 05(16.12%) were female. Out of 31 patients 01(03.22 %) had prolapse at the level of L3-L4, 23(74.19%) had at the level of L4-L5 and 07(22.58%) had at the level of L5-S1. In this series the most common causes of muscle weakness in EHL. Out of 31 patients, 22 (70.96 %) patients had weakness in EHL. 08 (25.80%) cases had weakness in FHL and both muscle weakness in 01 (3.22%). Out of 31 patients, 30 (96.78%) patients had preoperative sensory deficit and 03(09.67%) patients had postoperative sensory deficit, which is statistically significant. In preoperative period, moderate pain in 27(83.87%) patients, severe pain in 04(12.90%) patients. In postoperative period had no pain in 22(70.96%) patients, mild pain was noted in 08(25.08%) patients, moderate pain in 01(03.22%) patient. 20(64.51%) patients had para spinal muscle spasm in the preoperative period. Postoperative mean SLR was 81.94 ± 4.774 degree and range was 70?-90?, which was significantly improved. 29 (93.54%) patients had normal spine movement and 02 (06.45%) patients had restricted movement after 3 months of follow up. The minimum period of duration for follow up was 3 months and maximum duration of follow up was 12 months..Conclusions:By considering all aspects fenestration and discectomy is a better technique in the context of our country with the advantage of less tissue injury, good spinal function, smooth patient recovery, improve working status with early rehabilitation and maintain clinical efficacy.
ABSTRACT
In Bangladesh prevalence of kidney diseases is increasing day by day and it was observed that renal medulla is affected less in earlier period of life but in late period it becomes affected more. Moreover renal mass changes with age which affecting the medullary mass and consequently the number of medullary pyramids. So the present study was carried out to evaluate anatomical features of medulla and to count the medullary pyramids with age related changes in the number of the pyramids in Bangladeshi people. Study type: Cross sectional analytical type of study. Place and period of study: Department of Anatomy, Mymensingh Medical College, Mymensingh, Bangladesh from January 2004 to June 2005. Materials and methods: A total of 70 fresh human kidneys of both sexes and sides were collected from the morgue of Mymensingh Medical College at postmortem. The selected cases were between 5 to 60 years of age. The samples were divided into 3 different age groups (A: 05-15 years, B: 16-35 years, C: 36- 60 years) to observe the variations in number of medullary pyramid of kidney in different age groups. Results: Among three groups, highly significant (<0.001) differences were found statistically in the number of medullary pyramid. Conclusion: There were changes in the number of medullary pyramid of kidney in different age groups.
ABSTRACT
We describe here two cases, one male and one female, both age 40 years, with visceral leishmaniasis and HIV-1 co-infection. The female patient had features of Koch's abdomen. The male patient had features of tuberculous lymphadenitis and bilateral pleural effusion more marked on the right side. Both were treated with highly active antiretroviral therapy, antituberculous drugs, antibiotics, antifungal medicine (fluconazole) and miltefosine. Both patients showed marked improvement with therapy.