ABSTRACT
A hospital based cross sectional study was carried out to analyze diurnal variation of stroke and their association to sleep awake cycle. Four hundred and two patients of stroke admitted in different Medicine Units of Faridpur Medical College and Dhaka Medical College Hospitals from July 2012 to June 2013 were chosen using purposive sampling technique. Enrolled patients were with their first stroke, subsequently proved by CT scan of brain. The initial clinical diagnosis of stroke was made from history and examination obtained from the patient himself or from his/her attendant. The time of onset of stroke was recorded by attending doctor at the time of assessment and recorded on a fixed proforma. Patient who could not give history properly or had no responsible attendant and who had history of head injury, intracranial space occupying lesion or bleeding disorder were excluded from the study. Age ranged from 25 years to 98 years with mean age of 62.02 years (+_SD 11.75 years). Out of 402 patients 59.7% suffered from ischemic stroke. Highest incidence of stroke (26.9%) occurred between 4:01am to 8:00 am and lowest (7.5%) between 8:01 pm to 12:00 am. Among the subtypes, ischaemic stroke has shown a single peak incidence at 4:01 to 8:00 am and lowest between 8:01 pm to 12:00 am. 50 % of ischaemic stroke cases developed between 0:01 am to 8:00 am. In this study, maximum number of patients developed hemorrhagic stroke between 4:01 am to 8:00 am (25.9%) and lowest number developed hemorrhagic stroke between 12:01 pm to 4:00 pm (9.3%). This study confirms the diurnal variation of both hemorrhagic and ischaemic stroke in Bangladesh and most of them occurs in early morning after wakening.
ABSTRACT
This study; assessing existing practices in the operating theatre regarding hand washing; disinfection and sterilisation; was conducted at Khartoum North Teaching Hospital. As far as we know; this is the first study of its kind since the inauguration of the hospital in 1950. A total of 55 health personnel working in the operating theatre participated in the study. These included nurses and environmental service personnel (housekeepers and sterilisation and disinfection personnel). Knowledge and practice were evaluated using multiple choice and direct interview questions. Operation theatre sterilisation and disinfection practices were monitored using checklists modified from World Health Organization recommendations. A marked lack of knowledge and defective attitudes and practices were observed among a large number of personnel. It was observed that 51of the nurses were 46 years of age or older and that two-thirds had only a primary and intermediate school level education. The study recommends the upgrading of the operating theatres and additional training and education of staff. Theatres should be provided with facilities for proper disinfection and waste disposal. Qualified nurses should be employed. We also recommend the establishment of an infection control committee. The role of the committee would include the planning and execution of hygiene policies. In addition; planning and organising training courses in infection control should be seen as a priority
Subject(s)
Attitude , Disinfection , Hand Disinfection , Hospitals , Operating Rooms , Sterilization , TeachingABSTRACT
To compare the surgical outcome of canal wall up procedure with reconstruction versus without reconstruction, considering recidivism, otorrhea and hearing level. Fifty two patients with middle ear cholesteatoma were involved in this study. 26 patients were submitted to canal wall up with reconstruction and 26 patients, to canal wail up without reconstruction. cholesteatoma was attic in 32.7%, atticoantral in 36.5% and extensive in 30.8%. cholesteatoma residual or recurrence was found in 10 patients [19.2%] during the three years period of follow up. seven out of them were children, [2 in attic region with reconstruction, 2 in atticoantral with reconstruction and 3 in atticoantral without reconstruction, one in extensive with reconstruction and 3 in extensive without reconstruction. Otorrhea in attic was 45.5% in canal wall up with recons/ruction and 50% after without reconstruction, in atticoantral was 50% and 54.4% in canal wall up with and without reconstruction respectively and in extensive cholesteatoma was 42.9% after canal up with reconstruction and 44.4% after without reconstruction. There was statistically significant hearing improvement [8. 91dB] after canal wall up with reconstruction in attic cholesteatoma while decreased by [2dB.] after canal up without reconstruction, in atticoantral and extensive cholesteatoma the hearing gain was insignificant. surgery should be planned according to the site, size of cholesteatoma and age of the patient. One stage tympanoplasty is not recommended for childhood or for extensive adult cholesteatoma but only for attic cholesteatoma in adult
ABSTRACT
The objective of this work was to study the disease pattern in colorectal carcinoma patients, evaluate the results of the therapy adopted and to speculate the possible advances which can improve the results of treatment. A retrospective analysis of 97 patients with rectal adenocarcinoma treated at the Clinical Oncology Department and the Surgical Oncology Unit at Mansoura University Hospital in Egypt in the period from January 1998 to December 2003 was done. The patients' age, sex and presenting symptom were recorded. The tumor grade and clinical staging were collected, then the treatment plan and survival data were recorded. The mean age of the studied group was 42 [16-80] years, 54 were males and 43 were females. Seventy-two cases had curative surgery, abdominoperineal resection [APR] in 45 patients and low anterior rectal resection [LAR] in 25 patients. Eighty-seven patients received radiation therapy; of them, 66 cases received postoperative radiation therapy, 6 patients preoperative and 15 palliative irradiation. Eighty-three patients received chemotherapy, 5-Fu and leucovorin being the commonest regimen received. The local recurrence rate in this study was 8.4%. The 5-year disease free survival and overall survival were 54% and 56.5%, respectively