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Background: There is no consensus in the literature on the effects of the development of hydrocephalus on survival and disability after intracerebral haemorrhage (ICH) and the benefits of external ventricular drainage (EVD). This study is planned to describe the role of external ventricular drainage in treating patients of spontaneous, either primary or secondary, intraventricular haemorrhage with hydrocephalus.Material & Methods:A hospital based prospective interventional study was conducted in the Department of Neurosurgery of Dhaka Medical College Hospital, which is a tertiary level hospital, from April 2016 to September 2017.Total 42 patients of spontaneous intraventricular haemorrhage, either primary or secondary, with hydrocephalus were selected for this study. All the collected data were entered into IBM SPSS software, Version 24. For statistical analysis, paired t-test to compare the preoperative GCS with postoperative GCS at 24 hours was done.Results:Among 42 patients, age range was 26-75 years with the mean age 65.2 � 10.87 years. Male were 26 (61.9%) and female were 16 (38.1%). Male-Female ratio was 1.625:1. No patient needed conversion of EVD into VP shunt. EVD drain became blocked in 5 cases which were managed accordingly. 5 patients developed ventriculitis among which 2 patients died and rest 3 improved with antibiotics.Conclusions:The results of present study shows that EVD has a good role in the treatment of spontaneous IVH with hydrocephalus when ICH volume is low (<30ml) and modified Graeb Score is low (?10 found in this in this study. Preoperative higher GCS or initial improvement in GCS or initial improvement in GCS at 24 hours positively correlates with Glasgow outcome scale which is an indication of good function outcome.
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Introduction: Infection is the invasion of the body by thepathogenic micro-organisms with consequent local andsystemic effect. For this, a sufficient number of pathogens mustenter the tissues, overcome the patients' resistance andmultiply. The commonest organisms are staphylococcusaureus and gram-negative intestinal bacilli. Streptococcuspyogenes are not infrequent.Objective: The main purpose of this research is to make acomparative study on causative micro-organisms for postoperative wound infection between first and subsequent casesin routine surgical procedure.Method: Incidence of wound infection between first andsubsequent cases in routine surgical procedure was thesubject matter of this study. In this study 228 cases have beenstudied. Of these cases, 76 were the 1st case, 76 were 2ndcase, and 76 were the 3rd case in 76 routine operation days.The study duration was from September 2015 to August 2016.Result: After numerous information and examinationinvestigation; this study revealed that maximum woundinfection was due to Escherichia Coli.Conclusion: The study concludes that Escherichia coli werethe commonest organism isolated from infected wounds whichis the inhabitant of gastrointestinal and biliary tracts.
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Objective: In this study our main aim to evaluate the outcomeof primary rigid internal fixation of displaced fracture neck ofthe femur with muscle pedicle bone graft in young adult.Methodology: This prospective observational study wasconducted at National institute of traumatology and orthopaedicrehabilitation (NITOR), Dhaka from July 2003 to June 2005.During the study, recent neck femur fracture 12 cases, inbetween age 20-55 years irrespective of gender were taken asa sample.Results: In the experiment, 75% were male patient and 25%were female patients. 66.67 % patients with type 1V fractureand 33.33% patients were with type III fracture. Also, after thetreatment. 83.33 % patients obtained satisfactory result and16.67% was unsatisfactory.Conclusion: From our study we can conclude that thistechnique is especially applicable in early days of fracture toachieve union and revisualization of the proximal fracturefragment and prevent non-union or avascular necrosis. Thefollow up period of this initial study is short, long-term follow upand evolution of the viability of this procedure should provideadditional useful result.
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Background: Coronary Heart Disease (CHD) is the most common category of the heart disease and is found to be the single most important cause that leads to premature death in the developed world. Recognizing a patient with ACS is important because the diagnosis triggers both triage and management. cTnI is 100% tissue-specific for the myocardium and it has shown itself as a very sensitive and specific marker for AMI. Ventricular function is the best predictor of death after an ACS. It serves as a marker of myocardial damage and provides information on systolic function as well as diagnosis and prognosis. The study aimed at investigating the impact of LVEF on elevated troponin-I level in patients with first attack of NSTEMI.Methods: This cross-sectional analytical study was conducted in the department of cardiology in Mymensingh Medical College Hospital from December, 2015 to November, 2016. Total 130 first attack of NSTEMI patients were included considering inclusion and exclusion criteria. The sample population was divided into two groups: Group-I: Patients with first attack of NSTEMI with LVEF: ≥55%. Group-II: Patients with first attack of NSTEMI with LVEF: <55%. Then LVEF and troponin-I levels were correlated using Pearson’s correlation coefficient test.Results: In this study mean troponin-I of group-I and group-II were 5.53±7.43 and 16.46±15.79ng/ml respectively. It was statistically significant (p<0.05). The mean LVEF value of groups were 65.31±10.30% and 40.17±4.62% respectively. It was statistically significant (p<0.05). The echocardiography showed that patients with high troponin-I level had low LVEF and patients with low troponin-I level had preserved LVEF. Analysis showed that patients with highest level of troponin-I had severe left ventricular systolic dysfunction (LVEF <35%) and vice versa-the patients with the lowest levels of troponin-I had preserved systolic function (LVEF ≥55%). In our study, it also showed that the levels of troponin-I had negative correlation with LVEF levels with medium strength of association (r= -0.5394, p=0.001). Our study also discovered that Troponin-I level ≥6.6ng/ml is a very sensitive and specific marker for LV systolic dysfunction.Conclusions: The study has enabled the research team to conclude that the higher is the Troponin-I level the lower is the LVEF level and thus more severe is the LV systolic dysfunction in first attack of NSTEMI patients.
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Background: The rationale of determining the percentage ofanalgesics used in postoperative period is to determine the realutilization of opioid sparing effect of nonsteroidal antiinflammatory drugs and the concept of multimodal analgesia.Objectives: To determine the cost of opioids consumptionbecause the opioids are expensive.Methods: Total 541 patients were selected to find out thetypes of analgesics are being used in the postoperative eperiod irrespective of the types of operation and anaesthesia,premedication by analgesics and intraoperative analgesicsused or not. Patients were divided into several age groups.Results: In the existing prospective cross sectional study it isviewed that combination of intramuscular injection of pethidineand nonsteroidal anti-inflammatory drugs (either in suppositoryform or intravenous or intramuscular route) have the highestpercentage in postoperative pain relief.