Effects of Griseofulvin in the Treatment of Lichen Planus -A Study in BSMMU.

Lichen Planus (LP) is an inflammatory disorder of skin, mucous membranes, nails and hair. There are various modalities of treatment but none is curative. This prospective therapeutic trial was done among patients with lichen planus at the outpatient department of Dermatology & Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka between November 2001 and April 2002. Total 20 patients were taken of them 12 were male and 8 were female with male to female ratio 3:2. Age of the patients was between 10 to 50 years. Patients were diagnosed clinically & confirmed histologically. They were treated with griseofulvin 500 mg daily for 6 months. Out of 20 patients, 8 had only oral lesions, of them 2 (25%) showed complete response, 3(37.5%) showed moderate improvement and 4 (37.5%) showed no response. Other 12 patients had lichen planus involving skin without oral mucosa, of them 4 (33.3%) showed moderate improvement, 4 (33.3%) showed no response and 4 (33.3%) patients worsens with treatment. So, success in patients with cutaneous lichen planus is less likely; however, griseofulvin may afford relief in selected patients with oral lesion. This study indicates that further prospective placebo controlled studies are needed to clarify the efficacy of griseofulvin in lichen planus.

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.

A comparison of stapled vs handsewn anastomosis in anterior resection for carcinoma rectum.

The merits of stapled versus hand sewn anastomosis were evaluated in a prospective randomized study of 60 patients undergoing resection for rectal cancer. The analysed factors included the time required for construction of anastomosis, post operative complications, local recurrence, disease free state and survival. Hand sewn anastomosis was performed in two layers with 3/0 silk in 30 cases and the stapled anastomosis with EEA staplers in 30 cases. The anastomosis time averaged 24 minutes in the suture group and 16 minutes in the stapling group. Five post-operative complications occurred in each group. Six patients of the hand sewn group developed local recurrence as a first sign of treatment failure compared to four patients in the stapled group. The average time of study was 41 months. No significant difference was found in the overall survival pattern of the two groups.

Experience in elective hepatic resection.

A study was conducted on 35 elective hepatic resections performed by one surgical team over a period of 5 years with 14% postoperative mortality. The indications for hepatic resection were primary hepatocellular carcinoma in 20 cases (57%) and metastatic tumours from colorectal cancer in 12 cases (34%). Underlying cirrhosis of liver was found co-existent in 35% of patients of hepatocellular carcinoma. The 3-year actuarial survival rate after resection for HCC and metastatic tumour was 30% and 42% respectively.

Gastric cancer: a critical analysis of surgical treatment and long term survival.

Results of consecutive study of 120 cases of carcinoma stomach treated by one surgical team over a period of 10 years (1980-89) are presented. Maximum cases were in the sixth and seventh decades with male to female sex ratio of 2.5:1. The lesion in most cases were in the gastric antrum. Distal tumours were more of poorly differentiated histology compared to proximal tumours. Eighty-three out of 120 (69%) patients underwent surgical resection. In 50 patients it was in the form of a subtotal and distal gastrectomy. Only 5 patients underwent a total gastrectomy. In 70 cases the resection which involved en bloc removal of involved part of stomach including adequate proximal and distal free margins, omenta and perigastric lymph nodes and considered absolutely curative in 8 cases being no disease. The overall 5-year-survival figure was 18%. However, taking only the resected cases into account, the 5-year survival rate was 27%. The low survival figure can be attributed to a very small number of early cases encountered.