Rangpur Medical College Hospital Research Articles

Demographic Profile of Spinal Cord Injury (SCI): A Hospital-based Prospective study in Bangladesh

Purpose: To provide an overview of demographic characteristics of spinal cord injury (SCI) in Bangladesh. Methods: The study was conducted between 1st January and 31st December 2012 at 5 hospitals: Centre for the Rehabilitation of the Paralysed (CRP) in Savar, National Institute of Traumatology & Orthopaedic Rehabilitation (NITOR), Bangabandhu Sheikh Mujib Medical University (BSMMU), Rangpur Medical College Hospital, and Chittagong Medical College Hospital. 600 SCI cases from these tertiary hospitals were enrolled, and data was collected from those who met the study criteria, using a structured questionnaire developed on the basis of SCI core data set. Data was processed and analysed by SPSS version 16. Results: The male/female ratio was 4.5:1. Mean age at injury was 34.53 years (16–83 years). The cause of SCI was falls for 34.8% and RTA for 25.5% of the clients. 83.5% of SCI was traumatic and 16.5% was non-traumatic in origin. Only 9.5% of the clients were directly admitted to tertiary hospitals while 90.5% had intermediate admission before that. One-third (33.2%) of the clients used ambulance for intra-hospital transfer. 70.5% of the injury resulted in paraplegia and 29.5% in tetraplegia. Thoraco-lumbar junction (T11-L2) was the region most commonly involved, accounting for 38.7% of all cases. Overall 58.7% SCI cases were found with complete injury (ASIA-A) and 41.3% with incomplete injury during admission. 20.8% of the clients were admitted with pressure ulcer. The study found 27.2% of cases were operated on. The in-hospital mortality rate was 3.3%. Limitation: The pre-hospital fatalities were not included in the study. During data collection, extent of SCI was found in only 507 cases instead of all 600 enrolled. Conclusions: This study could contribute to the establishment of an effective prevention programme and comprehensive SCI management in Bangladesh.

Comparison between Invasive & Non-Invasive Diagnostic Evaluation of Tuberculous Peritonitis In Our Prospective

This cross sectional study was carried out in the department of gastroenterology, Rangpur Medical College Hospital, Rangpur from January 2014 to July 2014 to compare between Invasive & Non-Invasive Diagnostic Evaluation of Tuberculosis Peritonitis In our prospective in clinically suspected patients. Total 30 patients (age 39.69±21.26, 18M/12F) with clinical suspicion of peritoneal tuberculosis were included in this study after analyzing selection criteria. Laparoscopic peritoneal biopsy with 'histopathological' diagnosis was considered as gold standard against which accuracies non-invasive test of two biomarkers (ADA & CA-125) were compared. Cut off value of ADA and CA-125 is 24 U/l, 35 U/ml respectively. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ADA as a diagnostic modality in peritoneal tuberculosis were 87.5%, 83.33%, 95.45%, 62.5% and 86.67% respectively whereas CA-125 was found to have 83.33% sensitivity, 50% specificity, 86.9% positive predictive value, 42.85% negative predictive value and 76.6% accuracy. Both biomarkers were simple, non-invasive, rapid and relatively cheap diagnostic test whereas laparoscopy was an invasive procedure, costly & requires trained staff and not without risk and also not feasible in the entire centre in our country. So ascitic fluid ADA and serum CA-125 was important non-invasive diagnostic test for peritoneal tuberculosis.Medicine Today 2015 Vol.27(2): 20-22

Outcome of tetanus patients admitted in Rangpur Medical College Hospital

<p><strong>Background:</strong> Tetanus remains one of the major public health hazards of the developing world. Mortality is much lower in the developed world because of the availability of facilities, unlike in most developing countries' Objectives: This study was aimed to determine the outcome of tetanus patients admitted in infectious disease unit of Rangpur Medical College Hospital. <strong>Methods:</strong> A total of 91 cases of tetanus patients were seen in the 18 month period with a mean of 5 cases per month; they are diagnosed and managed for tetanus in the medical wards from January 2011 to June 2012. The data were retrieved from their case records and analyzed. <strong>Results:</strong> There were thirty one deaths, accounting for an overall mortality of 34.16o.Total fifty six patients were cured among which sixteen (17.67%) were cured with complication and four (4.4%) patient were absconded. Mortality was high 45.84% (11 patients out of 24) ≥40 years age, whereas low 29.85 (20 patient out of 87) in <40 yea15 age (45.84% vs 29.85%). Mortality rate was also higher among female than male patients (34.66% vs 33.85%). Farmers experienced more death than non-farmer (4l.l8% vs 29-82%, P<0.05). Mortality was higher in patients who had not received any medical treatment for their wound than in patients who had received it for their wound (52.78% vs 21.81%, p<0.05). Patients with short incubation period of less than one week had higher mortality in comparison with those who had incubation period more than one week (53.33% vs 23.25%, P<0'05). Of the 91 patients, fifty six (64.34%) were alive, though four remained in a persistent vegetative state due to tetanus toxin-induced brain damage and another two required a below knee amputation of the left leg. Hence, 40 were discharged well and 16 were discharged with permanent disabilities. <strong>Conclusion:</strong> The case fatality rate of tetanus has remained consistently high in the medical college. Factors that were significantly associated with high mortality included older age, and incubation period of less than 7 days. It is recommended that preventive immunization against tetanus be given to all Bangladeshis with secondary vaccination at adulthood.</p>

A Retrospective study on fracture of the mandible in the D.O.P.D of Rangpur Medical College Hospital.

Aims and 0bjective of present study: A retrospective study was performed involving 480 patients of fracture mandible who were attended in dental O.P.D of Rangpur Medical College Hospital during the period 2010 to December 2013. The aims of this study to analyze the fracture mandible cases and treatment modality by miniplate osteo synthesis. To evaluate causes, sites and different ages of fracture of mandible.Methods: Retrospective study of data were collected from the patients record file of dental O.P.D during the period January 2010 to December 2013.Result: A total of 480 cases were studied where miniplate immobilization were made in 288 cases. Arch bar immobilization were made in 144 cases and rest 48 cases eyelet wiring. Among the 288 case male female ratio was 2:1. The treatment modality relation to patient was same in number for male patients by mini plate immobilization where as arch bar immobilization was same for female patient in number. The reason behind may be due to fear of operation by female patient. The results are shown in pie chart and bar diagram.Conclusion: Using this research results, a great effort was made to provide better management of fracture mandible patient to the population of at or around the city of Rangpur.Mandibular fracture were more present in male between 20 to 30 years rta was about 50% cases. Rigid internal fixation by monocortical mini plate osteo synthesis provide good long time results and satisfactory cosmosis without any significant sequela[8].The more frequently affected region were symphysis menti and angle of mandible.Update Dent. Coll. j: 2016; 6 (1): 30-34

Role of pleural biopsy in diagnosis of unilateral pleural effusion:study of 50 cases in Rangpur Medical College & Hospital, Rangpur

Background: Pleural effusion remains the most common manifestation of pleural pathology. Sometime it is difficult to differentiate between tuberculous and malignant pleural effusion on routine cytological and biochemical examination. So pleural biopsy is an important tool for evaluating undiagnosed pleural effusion.Aim: To find out the role of pleural biopsy in the diagnosis of unilateral pleural effusion.Methods: This observational study was conducted in the Indoor patient department of Medicine in Rangpur Medical College Hospital from 01.01.2014 to 30.06.2014. All patients having unilateral pleural effusion above the age of 15 years irrespective of sex, race and religion was enrolled in this study.Results: Total fifty cases were enrolled in this study. Age of the patients varied from 16 to 78 years (Mean ±SD, yrs: 47±31.0). Thirty six (72%) patients were male and fourteen (28%) were female. 9 patients (18%) were of higher socio-economic status, 13 (26%) patients were from lower class, and 28 (56%) were from middle class. Majority (36%) of the patients were farmer, followed by 22% were businessman, 18% were service holder and 16% were housewives. Out of 50 patients, Nineteen patients (38%) were smoker and rests (62%) were non-smoker. Common presenting complaints were fever (78%), respiratory distress (62%), cough (56%), chest discomfort (38%) and weight loss (32%). General physical examination findings revealed 62% having different grades of anaemia followed by clubbing in 22% cases. Respiratory system examination revealed 56% having left sided pleural effusion followed by 44% right sided pleural effusion. 36% shows shifting of trachea. Regarding pleural fluid analysis, color of pleural fluid was straw in most cases (42%) and sixteen cases (32%) had hemorrhagic fluid. Mean total cell count in pleural fluid was 1449.1/c.mm. Most (88%) had lymphocyte predominance. Mean protein in pleural fluid was 5.6 gm/liter. Radiological examination revealed that maximum patient (56%) having left sided effusion and total 18 patients having shift of trachea. Close pleural biopsy for histopathological study revealed maximum (36%) were different types of malignancy, 24% chronic granulomatous inflammation consistent with tuberculosis, 16% shows non-specific chronic inflammation and 24% cases showed no abnormal findings or pleural tissue not available or inadequate tissue for histological report. Out of total 18 cases of malignancy, 08 revealed adenocarcinoma, 03 revealed metastatic adenocarcinoma, 02 revealed non-hodgkin’s lymphoma, 02 malignant mesothalioma and 03 of them revealed poorly differenciated carcinoma.Conclusion: In this study male are predominant. Most of the respondent was non-smoker. Most common presenting complains were fever, respiratory distress, cough, chest discomfort and weight loss. Most of general physical examination findings were anamia and clubbing. Respiratory system examination findings were features suggestive of pleural effusion (56% left sided and 44% right sided), 36% having shift of trachea. chest x-ray findings of most (56%) of the study population were left sided pleural effusion. Close pleural biopsy for histopathological study revealed maximum (36%) were different types of malignancy followed by chronic granulomatous inflammation consistent with tuberculosis (24%).Bangladesh J Medicine Jul 2016; 27(2) : 62-67

Bronchoscopy in Rangpur Medical College Hospital – Our Experience of 02 Years

Background: Bronchoscopy can play a major role in both diagnosis and treatment. Diagnostic bronchoscopy is a useful tool for the diagnosis of pulmonary lesions particularly bronchogenic carcinoma and pulmonary tuberculosisAim: To find out the role of fibre-optic bronchoscopy in the diagnosis of pulmonary diseases.Methods: This observational study was conducted in the Indoor patient, Department of Medicine in Rangpur Medical College Hospital. Of all patients aged 18 years and above Undiagnosed pulmonary lesion in the medical wards between October 2012 to October 2014.Results: Out of 256 cases, mean age ±SD was 61.01(±11.51), minimum age was 23 and maximum age was 86 years. Majority 84% were male and 16% were female. Most of the respondent were smoker whereas (82%). Most common presenting complains were cough, dyspnoea, haemoptysis and fever 83%, 59.3%,53% and 36% respectively. General Physical examination findings, 97% were anamia and clubbing were 41% and cyanosis 02%. Respiratory system examination findings, 54% were features suggestive of complete collapse, 15% features suggestive of consolidation and 31% normal chest findings. Chest x-ray findings of the study population, 25.8% were dense homogenous opacity involving right or left lung field, 17.9% were complete collapse of affected lungs , 5.5% were right middle lobe collapse, 4.3% Unilateral hilar lymphadenopathy, 7.03% were elevation of hemidiaphragm of affected site and 7.03% were pleural effusion. 6.6% patient had normal CxR. In present study shows bronchoscopic findings in patients studied, Vocal cord paralysis were 9.3%, Right main bronchus were 15.6% , Right upper lobe bronchus were 7.03% , Right middle lobe bronchus were 7.8%, Right lower lobe bronchus were 9.8%, Left main bronchus were 14% , Left upper lobe 4.3%, Left lingular were 1.9% and Left lower lobe bronchus were 9.3%.In this study shows histologhical findings majority 18% were squamaus cell carcinoma,8.2% were small cell carcinoma,2.3% were adeno carcinoma,6.6% infiltration of Inflammatory cell and granuloma 1.2%.Conclusion: In this study male are predominant. Most of the respondent was smoker. Most common presenting complains were cough, haemoptysis, fever and chest pain. Most of general physical examination findings were anamia and clubbing. Respiratory system examination findings were features suggestive of complete collapse, features suggestive of consolidation and normal chest findings. chest x-ray findings of the study population were complete collapse of affected lungs, rtight middle lobe collapse, Dense homogenous opacity involving right or left lung field, Unilateral hilar lymphadenopathy. Bronchoscopic findings were vocal cord paralysis, right main bronchus, right upper lobe bronchus, right middle lobe bronchus, right lower lobe bronchus, left main bronchus, left lingual and left lower lobe bronchus. Histologhical findings majority were squamaus cell carcinoma. Most of the patient poorly differentiated carcinoma among the study subjectsBangladesh J Medicine Jan 2016; 27(1) : 16-21

Ponseti Technique is the Best Option for the Treatment of Idiopathic Congenital Club Foot by the Age of Two Years

Club foot is the commonest congenital deformity in babies. Around 80% of the cases occur in developing nations. There are many option for treating club foot, Ponseti technique is one of them. This prospective interventional study was carried out at the Department of Orthopaedic & Traumatology, Rangpur Medical College Hospital, over period of 3 year from 22/09/2011 to 22/12/2014. One hundrad and Fifty patients of two hundrads and twenty three foots were treated by ponseti technique and followed up for the purpose of this study. Both rigid and non rigid variety of club foot were treated irrespective of sex and side of foot involvement. Pirani scoring system was used to assess the severity of deformity, needs of tenotomy and evaluation of result. All the patients were treated by Ponseti technique, only 83 (11.1%) foot by plaster, 140 (88.9%) foot required tenotomy. There were complication of 29 (13%) foot of 19 patients in the form of plaster sore. All patients were under bracing protocol. In this study it is found that 94.61% satisfactory result. So Ponseti technique is a safe, effective & low cost and easily acceptable. So it is the best option for the treatment of idiopathic congenital club foot under the age of two years.Chatt Maa Shi Hosp Med Coll J; Vol.14 (2); Jul 2015; Page 27-30

Causes, Management and Immediate Complications of Management of Neonatal Jaundice ? A Hospital-Based Study

Background: Jaundice is very common in the neonatal period of life. Although it is not a major cause of mortality, it is an important cause of morbidity. So, assessment of the causes and risk factors of neonatal jaundice is very important.Objectives: The objectives of the study were to find out the causes of jaundice, its clinical features, evaluation of the outcome of current management strategy and complications encountered by the participating subjects following treatment.Materials and Methods: This prospective study was conducted in the Neonatal Unit of Rangpur Medical College Hospital (RpMCH) during July to December 2006. A total of 100 neonates having jaundice on admission or who developed jaundice following admission were included in the study. A number of investigations were done for the purpose of assessment of neonates and their icteric condition. The test statistics used to analyse the data were descriptive statistics, Chi-square (?2) and correlation tests.Results: In the present study the median age of the jaundiced newborns on admission was 5 days, while the median age of appearance of jaundice was 3.5 days. Most of the newborns exhibited jaundice 24 hours after birth and peaked by 3–4 days. Majority of the subjects (77%) had pathological jaundice and only 23% had physiological jaundice. This study shows septicemia was in 28% cases followed by asphyxia (20%), prematurity (18%), Rh incompatibility (15%), IUGR (11%) etc. Half of the newborns (51%) had serum bilirubin (indirect) >10 mg/dL. Gestational age and serum bilirubin was found to exhibit a negative correlation. Preterm babies also tend to develop severe to very severe jaundice more than their term counterparts (p<0.001). Birth weight was also found to bear a negative correlation with serum bilirubin. Low birth weight (LBW) babies also had a significantly higher tendency to develop severe to very severe jaundice (p<0.001). Of the 77 patients who were treated, about 64% received phototherapy, 61% received antibiotics and very few (5.2%) received exchange transfusion. Majority of the patients developed some sorts of complications. The predominant complications of phototherapy were irritability (40.8%) followed by skin rashes (26.5%), loose motion (20.4%) and dehydration (16.3%). Very few newborns (4%) had hyperthermia. All four babies who received exchange transfusion suffered from hypovolaemia, one developed hypoglycaemia and one exhibited anaemia.Conclusion: Neonatal jaundice is a leading cause of hospitalisation in the first few weeks of life throughout the world. Though management of unconjugated hyperbilirubinaemia in newborns has undergone changes based on emerging evidences, phototherapy and exchange blood transfusion are still the most commonly used effective modalities for lowering serum bilirubin level.J Enam Med Col 2015; 5(2): 104-109

Organophosphorus Compounds Poisoning: Picture in Rangpur Medical College Hospital, Bangladesh

Organophosphorus compounds (OPC) poisoning is a major public health problem in low and middle income countries. The incidence varies from country to country depending on easy availability of poison, socio-economic condition and educational background of the people. This study aimed to determine the frequency, outcome and aetiological aspect of OPC poisoning patient admitted in Rangpur medical college hospital. It was a cross sectional study carried out in the department of Medicine, Rangpur medical college hospital from 1st December 2011 to 30th November, 2012. During the study period a total of 703 patients have been studied. The most of the patients were between the age of 18- 40 years (91.9%), male (51.6%), married (71.3%) and from rural areas (67.8%). People of different occupations were involved in OPC poisoning, house-wives were the maximum (33.6%) followed by farmers (31.7%). 92% cases were suicidal and 8% accidental. Familial disharmony was the prime cause (92.3%) of suicidal motive. 88% of the patients were survived and 5% died. OPC poisoning is an important health care problem in our country. Improved awareness, restricting availability and banning more toxic organophosphorus compounds will reduce the incidence of OPC poisoning. DOI: http://dx.doi.org/10.3329/medtoday.v26i1.21313 Medicine Today 2014 Vol.26(1): 46-48

Hospital Acquired Infections in a Selected Tertiary Level Hospital of Rangpur City

Objectives: To find out the proportion, to determine the average length of stay at hospital and to estimate the cost of treatment for hospital-acquired infections in a tertiary level hospital of Rangpur City. Materials and Methods: This descriptive type of cross sectional study was conducted on purposively selected 200 admitted patients in a tertiary level hospital. Among them 100 were HAI patients and 100 were non HAL Data were collected through duly pretested interviewer administered questionnaire and observation checklist. Place and period of study: This study was conducted in Rangpur Medical College Hospital (RpMCH), Rangpur from January to June2011. Results: In this cross sectional study the highest percentage of HAI (42%) belonged to the surgery ward and the lowest percentage (19.%) belonged to medicine ward of the study hospital. According to the type of infections the surgical wound infection was found on the top (23%) and the cannula-associated infection at the bottom (5%) of the list. Respondents of both the polar age groups (<21 years and > 60 years) were found to be equally (27%) affected by HAI. Occurrence of HAI was found higher (57%) among the female respondents than their male (43%) counterparts. Highest number (48%) of HAI and lowest number (14%) of non- HAI patients were found to be visited by maximum number (?5) of visitors. Among the respondents who developed HAI, 42% had to stay at hospital for longest duration (21-25 days) but only 13% of their non- HAI counterparts had to stay for same duration. Among HAI patients 26% had to spend highest amount of money (Tk.20,0011- 25,0001-) but among non- HAI patients only 10% had to spend same amount of money for their treatment purpose. Conclusion: It has been revealed from this study that the occurrence of HAI was found higher among the patients with maximum number of visitors. Average length of hospital stay and cost of treatment of HAI patients were found higher than those of their non-HAI counterparts. DOI: http://dx.doi.org/10.3329/bjdre.v4i2.20247 Bangladesh Journal of Dental Research and Education Vol.4(2) 2014: 49-52

Demographic Characteristics and Pattern of Acute Poisoning in Rangpur Medical College Hospital

Bangladesh Journal of Medicine, Vol 23 No 2, 2012, Page 62-66 DOI: http://dx.doi.org/10.3329/bjmed.v23i2.14986

SPECTRUM OF ACUTE PHARMACEUTICAL AND CHEMICAL POISONING IN NORTHERN BANGLADESH

Background: Acute poisoning is a major public health problem in Bangladesh. It is a common method for suicide. A clear picture regarding clinical presentation, most commonly used toxic agents, background factors and outcome of poisoned patients is necessary in every region. The aim of this study was to investigate frequency and outcome of acute pharmaceutical and chemical poisoning cases in Northern Bangladesh. Methods: This was a retrospective descriptive study on poisoned patients with 18 years of age and above who were admitted to Rangpur Medical College Hospital during 1st December 2011 to 30th November 2012. Results: During the study period, a total of 956 patients were investigated. Males slightly outnumbered females (51.6%). The majority of patients (92%) were in the 18-40 year age-group. Regarding occupation, housewives were the most frequent (33.6%) followed by farmers (31.7%) and students (20.9%). Organophosphate compounds (OPC) were the most commonly used toxic agents (73.5%). Most of poisoning cases occurred following suicidal attempts (88%). Familial disharmony was the main cause of suicidal attempts (92.3%). Univariate Analysis showed that age less than 40 years, being married, living in rural areas and educational attainment below secondary level were significantly associated with an increased risk of poisoning (P<0.001). Conclusion: All tertiary hospitals should be well equipped with antidotes of OPCs and other supportive treatments in Bangladesh. Furthermore, strong rules must be applied to prevent the distribution of benzodiazepines without prescription. In addition, people with age of less than 40 years, housewives and farmers, rural residents and those with less educational attainment should be targeted for prevention and educational programs against deliberate self-poisoning.

Pre-Hospital and Hospital Management Practices and Circumstances behind Venomous Snakebite in Northwestern Part of Bangladesh

Background: Snakebite is the most important cause of envenomation in South Asia particularly in Bangladesh, though there is lack of data from the rural part of the country. About 82 species of snakes (28 venomous) exist in Bangladesh. In this study, demographic characteristics of the victim, circumstances behind the bite along with pre-hospital and hospital managements and outcomes were evaluated. Methods: It was a cross-sectional study during January 2010 to June 2012 at Rangpur Medical College Hospital. Only venomous snakebite cases were included and diagnosis was made on clinical syndrome. Descriptive statistics were presented using percentage and proportion. Results: Out of 28 patients (mean age: 31.7 years), 20 (71.4%) were males with a significant male-female ratio (2.5:1). Majority were farmers (46.4%) and most (50%) of the bites happened during household activities. Lag period between bite and hospitalization was ≤5 hours in 50% patients; 6 to 10 hours in 39.2% and >10 hours in 10.7% cases. 82.1% patients received ligature as pre-hospital first aid. Total 21 patients received anti-snake venom (ASV) in different dose regimens. 15 (53.5%) patients recovered while 13 (46.4%) died. Among 13 patients who died, 53.8% died within 2 hours, 15.3% within 3-24 hours and 30.7% after 24 hours post-bite. Conclusion: Snakebite has a significant impact on human health and economy through treatment-related expenditures and loss of productivity. Policy makers of Bangladesh should prioritize the issue to reduce future mortality and morbidity. Keywords: Poisoning, Snakebite, Bangladesh, Envenomation, Management

Study on Serum Levels of Thyroid Hormones and Thyroid Stimulating Hormone in Different Trimester of Normal Pregnancy

Objective: The present study was conducted to study the changes in serum levels of thyroid hormones and thyroid stimulating hormone (TSH) in different trimesters of normal pregnancy.&#x0D; Methods: This cross-sectional study was conducted in the Department of Physiology, Rangpur Medical College Hospital over a period 1 year from July 2008 to June 2009. Apparently healthy pregnant women aged between 20 - 35 years were consecutively included in the study. Patients suffering from thyroid disorders or any other systemic diseases and lactating mothers were excluded from the study. A total of 100 subjects - 75 pregnant women (25 selected from each trimester of pregnancy) and 25 non-pregnant women were purposively selected as case and control groups respectively.&#x0D; Result: The mean age was almost identically distributed between the two groups (23.8 ± 3.9 vs. 24.9 ±4.6, p = 0.343). Lower class patient was predominant in case and control group (68% vs. 64%, p =0.756). The mean serum T3 level was higher in case group compared to control group. The mean serum T3 level was identically distributed in 1st and 3rd trimester (p = 0.536 and p = 0.145 respectively) but significant difference was found in 2nd trimester (p = 0.001). The mean serum T4 level of control group did not experience any change throughout the whole observation period. The serum T4 level was 210 nmol/L at 1st trimester then it began to increase almost a plateau at 2nd trimester and then gradually dropped 232.2 nmol/L at third trimester. The mean serum TSH level was 1.1 mIU/L at 1st trimester then it began to increase sharply assumed a mean score 1.3 mIU/L at 2nd trimester. From 2nd trimester onwards it began to decrease upto the end of observation when no change in the non-pregnant women in 1st, 2nd &amp; 3rd trimester.&#x0D; Conclusion: Thyroid hormones (T3, T4) increase in the 2nd trimester of pregnancy and fall again in the 3rdtrimester but TSH does not experience any significant change throughout the pregnancy.&#x0D; Ibrahim Cardiac Med J 2012; 2(2): 19-23

Effect of therapeutic ultrasound on calcific supraspinatus tendinitis

Calcific tendinitis is an important cause of shoulder pain. There are various modalities used to treat calcific tendinitis. Ultra-Sound therapy (UST) is a non-invasive modality of treatment. It is not costly. The aims of the present study were to see the efficacy of UST on calcific tendonitis. This was a prospective study done at BSMMU, BIRDEM and Rangpur Medical College Hospital. All the cases with duration of illness more than three months, and diameter of stones more than 5mm were included in this study. Out of 26 cases 10(38%) were male, 14(54%) were housewife, 8(31%) were businessmen. UST were given to all cases for 10 minute with 1 to 1.5 W/sq cm for 12 doses. After 12 doses of UST all the patients became free from pain and restriction of movements. Radiographs of 24(92%) cases showed no calculi. Only two patients showed clinical improvement only but radiographs showed no change in caiculi and symptoms returned after one and two months respectively.

Expectation of Patients from Doctors

Doctors are produced to meet the health need of the people. People, as a patient have many expectations from a doctor. Doctors often don't know those expectations. The objective of this study was to find out the expectations of the patients from doctors and the goal is to make the doctors aware of these expectations so that they give due attention to those expectations. Waiting patients in GPs' clinic and the patients waiting in the out patient department of the Upozilla Health Complex and Rangpur Medical College Hospital were interviewed to know their expectation from doctors. Focus group discussion was done with community people to know their expectation from doctors when they need health care. It was found that most people expects good treatment (70.70%), greetings from doctor (51.91%), good history taking (100%), attentiveness (78.02%),to be allowed to narrate their ailments without interruption (87%), privacy (75%), clarification of prescription (75.15%), referral if needed (98%), dietary advice (67%), information about the ailment (75.79%), partnership in decision making (72.92%) and confidentiality (46.49%). DOI: 10.3329/jbcps.v26i1.4226 J Bangladesh Coll Phys Surg 2008; 26: 3-9

Correlation of the Laboratory Findings with a Etiology of Patients Presenting with Fever followed by Altered Consciousness in a Teaching Hospital

Consecutive fifty subjects having fever with altered consciousness admitted into medical wards in Rangpur Medical College Hospital, Rangpur were selected to find out the aetiology and its correlation with laboratory findings of the subjects. Subjects having prolonged fever, (more than 21 days) pregnancy, trauma, drug intoxication, cerebrovascular disease and metabolic causes including liver diseases were excluded from the study. Study revealed that majority of the study subjects were below 39 years (76%) of age and most of them were male (80%). Predominant cases were found to be pyogenic meningitis (44%), followed by encephalitis (32%), cerebral malaria (20%) and tubercular meningitis (4%). Neutrophilic leucocytosis, high cerebrospinal fluid protein, very high cell count and low sugar were a common observation in pyogenic meningitis while very high erythrocytic sedimentation rate was the main findings in tubercular meningitis and high lymphocytic count was observed in encephalitis as compared to other. So it is concluded that subjects suffering from fever with altered consciousness are 1. Predominantly male of young age group. 2. pyogenic meningitis is a predominant cause. 3. Cerebrospinal fluid findings were observed to have usual findings in disease of pyogenic meningitis, encephalitis and tubercular meningitis. doi: 10.3329/taj.v18i1.3300 TAJ 2005; 18(1): 25-29