Hirschsprung Disease Presentation and Outcome by nikeborome

VIEWS: 15 PAGES: 15

									2006 VOL 15 NO- 2
RESURGENT VECTOR-BORNE
DISEASES AS A GLOBAL HEALTH
PROBLEM -IN CONTEXT TO
BANGLADESH
Md. Mujibur Rahman1

HIRSCHSPRUNG’S     DISEASE,
PRESENTATION AND OUTCOME.
THREE YEARS EXPERIENCE IN
RANGPUR    MEDICAL COLLEGE
HOSPITAL

K H Rahman1, Syed M A Taleb2, M R
Islam1, M N Alam3

PATTERN OF DRUGS USED IN
DIARRHOEAL DISEASES IN ORT
CORNER
Moksuda Khatun1, Hamidul Haque
Khandker2

STUDY OF RISK FACTORS          IN
ENTERICFEVER IN CHILDREN
M A Mostakim1, Hamidur Rahman2, M
A Hye3, Animesh Majumder
USE OF ACETIC ACID INSTEAD OF
SULPHURIC ACID IN ZEIHL -
NEELSEN STAINING
Md. Mujibur Rahman1


LEFT SIDED GASTROSCHISIS WITH
   MUCONIUM ILEUS

Mohammad Nurul Islam1, M A Salam
Khan2, Md. Hamidul Islam3
CARCINOMA OF THE MALE BREAST
- A CASE REPORT

Swapan Kumar Nath1
GASTRIC TERATOMA – A REPORT
OF FOUR CASES

Md. Rezaul   Islam1,   Kazi   Habibur
Rahman1

INCIDENCE - AND COMPLICATIONS
   OF CHRONIC SUPPURATIVE -
   OTITIS MEDIA

M A Hye1, Nahas Farld2, M A Mostak3,
G H M Shahidul Haque4
Md. Mujibur Rahman5
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EPISTAXIS : AN UPDATE ON CURRENT MANAGEMENT

M A Hye1


RESURGENT VECTOR-BORNE DISEASES                     AS   A GLOBAL HEALTH
PROBLEM -IN CONTEXT TO BANGLADESH
                             Md. Mujibur Rahman1

The effects of globalization in exacerbating the risk of spreading infectious
diseases are mediated not only through the movement of people but also by the
increased mobility of disease vectors, livestock and other animals that may host
zoonoses, as well as the greater propensity for food-borne disease in
consequence of increasing legal and illegal trade.1
In the 120 years since arthropods were shown to transmit human disease,
hundreds of viruses, bacteria, protozoa, and helminthes have been found to
require a hematophagous (blood-sucking) arthropod for transmission between
vertebrate hosts). Historically, malaria, dengue, yellow fever, plague, filariasis,
louse-borne typhus, trypanosomiasis, leishmaniasis, and other vector-borne
diseases were responsible for more human disease and death in the 17th
through the early 20th centuries than all other causes combined. 2
Prevention and control programs are mainly based on controlling the arthropod
vectors. However, the benefits of vector-borne disease control programs were
short-lived. A number of vector-borne diseases began to reemerge in the 1970s,
a resurgence that has greatly intensified in the past 20 years I. Although the
reasons for the failure of these programs are complex and not well understood,
two factors played important roles: 1) the diversion of financial support and
subsequent loss of public health infrastructure and 2) reliance on quick-fix
solutions such as insecticides and drugs.)
During controlling vectors, in addition to use of safe insecticides or taking other
common measures, it should be emphasized upon the matter of migration of
these vectors through vehicles from one country to other countries.
In context to Bangladesh, India can be major source of those new types of
diseases like dengue. In India, dengue has been epidemic for several years. 5
Although dengue fever was documented in Bangladesh from the mid-1960s to
the mid-1990s, but an outbreak of dengue haemorrhagic fever has not been
previously reported.4 But in 2000, through mid November 5,575 hospitalized
dengue cases were reported to the Ministry of Health in Bangladesh, with a case-
                                                                                    42




fatality rate of 1.61%.4, 6, 7
Ades mosquito, the vector of this disease, can not fly more than 100 meters from
its residence8. So, there is less chance to move this vector from airport to
populating area of Dhaka, where dengue outbreak started first in Bangladesh.
Moreover, the airway communications from Bangladesh to India have been
established many years before liberation but there was no dengue outbreak
during this period. So, there is very little chance of transmitting the disease by
this route. Moreover, under the WHO International Health Regulation (IHR), all
international airports and seaports are kept free from all types of mosquitoes for a
distance of 400 meters around the perimeter of the ports. 8 But it is possible that,
the infected mosquito can travel via bus or train under their seats, in between
luggage and thus transmit the disease to other populating areas nearby the this
stoppage. The time of emergence of dengue outbreak in Bangladesh that
occurred first in Dhaka coincides with period after the introduction of bus
communication between Dhaka and Kolkata. So it will be logical to claim that the
infected vectors can easily migrate to Dhaka via bus from India. Now, the recent
introduction of railway communication can exacerbate the condition or import of
new diseases agents like Japanese B encephalitis, chikangunya that are known
to prevalent in many areas of India. So, it should be an urgent matter to prevent
such migration of vectors through vehicles like bus or train. The measures those
can be taken to limit the migration of vectors could be as follows: 1) Before each
starting, the train or bus should make free from any vectors by using effective
aerosols of insecticides before the passengers take their seats. 2) The
international train or bus should not be used for domestic traveling purposes. 3)
The stoppages for train or bus in both countries should be sufficiently away from
the localities and the areas should be carefully and regularly monitored for
vectors. 4) Traveler's quarantine should be strictly maintained. Our government
should create awareness among the peoples about the factors related migration
of different arthropod vectors urgently. If it is ignored, it will be not so late when
even a lay man will bother for uncommon diseases like Japanese B encephalitis,
chikangunya or other uncommon vector borne diseases as like as the situation of
dengue today.

  HIRSCHSPRUNG’S DISEASE, PRESENTATION AND OUTCOME. THREE
    YEARS EXPERIENCE IN RANGPUR MEDICAL COLLEGE HOSPITAL

            K H Rahman1, Syed M A Taleb2, M R Islam1, M N Alam3
                                                                                  42




Abstract:
A prospective study of 44 patients of HPD admitted in Paediatric Surgery ward of
Rangpur Medical College Hospital over a period of three years from January
2005 to December 2007 was conducted. Majority children 18 (about 41%)
presented over 1 year of age with severe constipation and abdominal distention.
15 children ( 34 %) presented in infant age group with same presentation as
children over 1 yr of age. 11(25%) children presented in neonatal age group and
mostly presented as acute intestinal obstruction.2 children presented with
perforation. 40 children had short segment and rest of 4 child had long segment
involvement. 3 staged operation was done in all the cases, Swenson Pull through
was done. Complications developed in 11pts. There were 7 death, 6 after 1st
stage and 1 after completion of 2nd stage.

Indexing Words: Hirschsprung’s disease, Presentation, Outcome.

 PATTERN OF DRUGS USED IN DIARRHOEAL DISEASES IN ORT CORNER
            Moksuda Khatun1, Hamidul Haque Khandker2


Abstract:
This prospective study, on going prescriptions, is to audit as well as to assess the
magnitude of rational prescriptions in diarrhoeal diseases served by qualified
medical prescribers in two selected units of RMCH. It was performed in ORT
corner and infectious ward of RMCH from Jan 2005 to December 2005. Total
number 2994 prescriptions from ORT and 2030 from infectious ward of RMCH
were collected from outpatient and inpatient department of both regions
respectively. Certain health parameters such as age, disease pattern, drug
utilization pattern and practice of generic name were studied. The uses of ORS,
ORS with cotrimoxazole and ORS with nalidexic acid were 100%, 66.36% and
33.64% respectively according to disease pattern in ORT comer and on the other
hand ORS, cholera saline and ciprofloxacin were used in diarrhoea 100% cases
and ORS, cholera saline, ciprofloxacin and metronidazole in dysentery 100%
cases in infectious ward of RMCH.

                    STUDY OF RISK FACTORS IN ENTERIC
                           FEVER IN CHILDREN
     M A Mostakim1, Hamidur Rahman2, M A Hye3, Animesh Majumder
                                                                                   42




Abstract:
The risk factors in children suffering from enteric fever were studied in 727
patients. There were 11 deaths during 5-years period of study. Young children (<
5 years of age) were suffered with higher rate of mortality and severe clinical
illness. The higher rate of diarrhoea, coated tongue, anemia, shock, convulsion
were significantly associated lower age (<5 years) of the children (the relative risk
with 95% confidential interval was assessed with p values<0.05). Among the
factors associated with increased risk of mortality were prolonged duration of
illness, delayed institution of therapy, hepatic involvement, low WBC count,
intestinal hemorrhage, prior treatment with more than 3 antibiotics were
significantly notable (the odds ration with 95% confidential interval and with p
values <0.05 were assessed carefully). The data provides evidence that typhoid
fever in children associated with increased risk of mortality and close attention to
mortality risk factors may lead to improve outcome of treatment.
Indexing Words: Enteric fever, Risk factors children.
                                                                                    42




       USE OF ACETIC ACID INSTEAD OF SULPHURIC ACID IN ZEIHL
                        - NEELSEN STAINING
                              Md. Mujibur Rahman1


Abstract:
Sulphuric acid used for decolorizing purpose in acid fast staining (Zeihl-Neelsen)
is a mineral acid, which is known to be a strong and a very much corrosive acid.
On the other hand acetic acid is an organic and a weak acid and never been
used as decolorizing agent in Zeihl-Neelsen (Z-N) staining. Incidentally, when
acetic acid is used in Z-N staining due to instant unavailability of sulphuric acid in
laboratory, it is found to be equally effective like sulphuric acid. Subsequently to
find out the consistent effectiveness of acetic acid as decolorizing agent in Z-N
staining the study was undertaken. For the last seven years, different specimens
including sputum, ascetic fluid, CSF, pleural fluid, skin discharge and joint fluids
were stained for mycobacterium tuberculosis using both 20% sulphuric acid and
20% acetic acid simultaneously. Total 14 cases of skin scrapings were stained
for mycobacterium leprae by 5% strength of both acids. There were no
differences among the positive findings by using sulphuric acid and by acetic acid
as decolorizing agent in acid fast staining for detection of mycobacterium. So, not
only the sulphuric acid, being a weak acid, acidic acid can also be used for the
purpose of Zeihl-Neelsen staining.

Indexing Words: Zeihl- Neelsen staining, Acetic acid use.
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            LEFT SIDED GASTROSCHISIS WITH MUCONIUM ILEUS

        Mohammad Nurul Islam1, M A Salam Khan2, Md. Hamidul Islam3


Abstract:
Gastroschisis, a congenital abdominal wall defect, usually occurs in right side of the
abdominal wall. We found a case of left sided gastroschisis of a premature baby and
managed surgically.

Indexing Words: Gastroschisis, mucomium ileus
                                                                                 42




                      CARCINOMA OF THE MALE BREAST
                             - A CASE REPORT

                               Swapan Kumar Nath1
Abstract:
A 54 years old male patient presented with complains of mass in the left breast for 6
months. Initially, it was painless but later on developed dull pain with ulceration of
areola and nipple. The lump was not fixed to the chest wall. Simple mastectomy was
done after having FNAC report of mass, which revealed duct cell carcinoma.
Histopathological evaluation of mass showed poorly differentiated infiltrating duct
cell carcinoma. After surgery, the patient was treated with loco-regional radiotherapy
followed by systemic chemotherapy. The case is very rare and very few of similar
cases have been reported so far in Bangladesh.
Indexing Words: Carcinoma breast male, male breast
                                                                              42




                                         GASTRIC TERATOMA
                         – A REPORT OF FOUR CASES

                   Md. Rezaul Islam1, Kazi Habibur Rahman1



Abstract:
Teratomas are tumors of mixed tissues, and in children the teratomas are seen most
often in the sacro-coccygeal region, mediastinum, gonads, retro-peritonium and
head neck region. Gastric Teratoma (GT) is very rare and usually occurs in males
and accounts for less than 1% of all teratomas occurring in children1. These tumors
may be benign or malignant, and complete excision of the tumor in either case
carries a good prognosis. Till date 119 cases of GT have been reported
worldwide2,3. We report 4 cases of G T in infants of age ranging from 42 days to 1
year.
                                                                               42




  INCIDENCE - AND COMPLICATIONS OF CHRONIC SUPPURATIVE - OTITIS
                               MEDIA

         M A Hye1, Nahas Farld2, M A Mostak3, G H M Shahidul Haque4
                           Md. Mujibur Rahman5


Abstract:
Fifty cases of chronic suppurative otitis media were studied in Rangpur Medical
College Hospital from September 2004 to August 2005 in the age group from 2 to 80
years. The maximum incidence is noted in second decade and this was followed by
third decade and then first decade respectively. Males (64%) are affected more than
female (36%) respectively. Among complications, extra cranial complications are
high (68%) and lowest complications were in combined form (4%) (both extra and
intracranial). Post auricular abscesses were commonest complication in extra cranial
group (35.29%). Among intracranial group, meningitis was most common
complication (66.6%).

Indexing Words: Otitis media, Complication CSOM.
                                                                                42




            EPISTAXIS : AN UPDATE ON CURRENT MANAGEMENT

                                     M A Hye1

Abstract: Epistaxis is a Greek word meaning "a dripping," especially of blood from
the nose. Epistaxis is one of the commonest ENT emergencies and panic among
common people. Although most patients can be treated within an accident and
emergency setting, some are complex and may require specialist intervention. It
occurs from the anterior or posterior portion of the nasal septum. There are multiple
risk factors for the development of epistaxis and appears to occur more often in
males than in females. It can affect any age group (highest incidence at ages
younger than 10 years and older than 50 years), but it is the elderly population with
their associated morbidity who often require more intensive treatment and
subsequent admission in to hospital. Treatment strategies have been broadly similar
for decades. However, with the evolution of endoscopic technology, new ways of
actively managing epistaxis are now available. Recent evidence suggests that,
combined use of stepwise management plans, should limit patient complications and
the need for admission.
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