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Mymensingh, Bangladesh

Imam M.A.,Mymensingh Medical College & Hospital
Mymensingh medical journal : MMJ

This descriptive, cross sectional, comparative and analytical study assessed the quality of life of major depressive patients and healthy controls. It was carried out in the department of psychiatry of Bangabandhu Sheikh Mujib Medical University (BSMMU) on patients of major depressive disorder according to structured clinical interview (SCID and diagnostic and statistical Manual) (DSM-IV) criteria. The study used world health organization quality of life scale (WHO QoL -BREF) Bangla version to assess QoL of major depressive patients. The study assessed eighty patients of major depressive disorder who were recruited purposively from the Department of Psychiatry, BSMMU who were above the age of 18 years irrespective of sex. Same number of age, sex matched hospital staff of different strata of the BSMMU were included in this study. The study shows that the all parameters of quality of life scales in patients (mean±SD) were Overall health (case 2.20±0.77 & control 3.79±0.52), Physical (case 2.77±0.383 & control 3.44±0.322), Psychological (case 2.53±0.353 & control 3.51±0.382), Social (case 2.88±0.65 & control 3.85±0.543), Environmental (case 2.87±0.533 & control 3.27±0.514) and overall quality of life (case 1.94±0.817 & control 3.71±0.556) which major depressive disorder were significantly reduced. Source

Per-operative shivering following spinal anaesthesia is a common problem in the operation theatre. Adequate management of shivering during operation is one of the goals of anesthesiologists for the benefit of the patient. Because there are many unpleasant and harmful effects caused by shivering in many patients especially respiratory and cardiac disease patients. For this reason aggressive and optimal treatment of per-operative shivering is essential to reduce the morbidity of the patients. Our observations were that occurrence of shivering was more in younger patients than older patients, thin patients than obese patients, anxious patients than non-anxious patients and more frequent in patients who received vasoconstrictor drugs, administration of fluid at running rate just before or during operation, administration of cold local anaesthetic agents (by taking drug from the freeze) into subarachnoid space. And shivering was better managed by administration of nalbuphine HCl and surface skin warming (wrapping of the skin). There are many studies regarding the incidence, prevention & treatment of post-operative shivering but there is no study regarding the incidence & treatment of per-operative shivering by nalbuphine following spinal anaesthesia. This study was designed to compare the anti-shivering efficacy and side effects (Nausea, Vomiting, and Somnolence) of tramadol hydrochloride with that of nalbuphine hydrochloride in the treatment of per-operative shivering following spinal anaesthesia. This study was also done to observe the incidence of shivering during operation following spinal anesthesia. Source

Miah A.H.,Mymensingh Medical College & Hospital
Mymensingh medical journal : MMJ

The present descriptive cross-sectional study was conducted in the Department of Medicine, Mymensingh Medical College Hospital, Mymensingh, Bangladesh over a period of one year during November 2009 to October 2010. The study was conducted to describe the variations in types of stroke (ischemic stroke and hemorrhagic stroke) during summer and winter. An attempt was also made to observe the frequency of common risk factors of stroke by seasons. A total of 292 patients of any age irrespective of sex fulfilling the WHO criteria of acute stroke and confirmed by CT scan were selected from consecutive admission in the Department of Medicine, Mymensingh Medical College Hospital. Detail history and thorough clinical examinations were done. Routine and relevant investigations were carried out. The mean age of the patients was 59.9±14.3 years. A male preponderance was observed in the study. In summer 66% of patients and in winter 34% of patients were presented. Ischemic stroke was present in 54.1% patients and 45.9% patients had haemorrhagic stroke. The study found that the frequency of ischaemic stroke during summer (62.4%) was significantly greater than that during winter (37.8%). The frequency of haemorrhagic stroke during winter (62.2%) was significantly greater than that during summer (37.6%). Hypertension was the most important risk factor and other risk factors were smoking, diabetes mellitus, tobacco chewing, ischemic heart disease, dyslipidemia, oral contraceptive pill, alcohol consumption, atrial fibrillation and past history of stroke. Increasing age was also noted as a risk factor (60.7% >60 years). Most of the risk factors were homogenously distributed between two seasons and between ischemic and haemorrhagic group. Hypertension was significantly higher in haemorrhagic stroke patients compared to ischemic stroke patients. Source

This prospective study was done for to see the efficacy of preoperative use of granisetron plus dexamethasone (Group A) & granisetron (Group B) alone for the postoperative prevention of nausea & vomiting after tonsillectomy operation. One hundred patients undergoing tonsillectomy & adenoidectomy operation under general anaesthesia who were admitted in the Mymensingh Medical College Hospital during the period from July 2008 to June 2009 with American Society of Anaesthesiologists (ASA) grade I & II with age 3-40 years, body weight 10-60 kgs, were studied. Observation of this study was analyzed in the light of comparison between the two groups. All results were expressed as mean±SEM. Age in Group A 15.98±1.028 & Group B 17.18±0.961 years; Weight in Group A 38.40±1.492 & Group B 39.76±1.561 kgs and operational duration in Group A 52.60±0.786 & Group B 52.70±0.823 minutes. The studied groups were statistically matched for age, weight, duration of surgery. We observed that the effects of combination of granisetron & dexamthasone are more than granisetron alone in prevention of nausea & vomiting after tonsillectomy operation. The frequency of vomiting was 4% in combination & 16% in single therapy which is statically significant (p<0.05). Source

Bari M.S.,Mymensingh Medical College & Hospital
Mymensingh medical journal : MMJ

The present study has been designed to compare the postoperative pain relief for inguinal hernia repair in children through wound infiltration with levobupivacaine with that provided by paracetamol administration per rectaly. This interventional study was carried out in the Department of Paediatric surgery, Mymensingh Medical College Hospital, Mymensingh and Dhaka Medical College Hospital, Dhaka, during the period from January 2009 to September 2010. A total of 120 patients were included in this study. Among them 60 patients in Group-A (study group) where post incisional wound infiltration with levobupivacain after inguinal herniotomy and before skin closure was done and 60 patients in Group-B (control group) where paracetamol was given per rectally after anesthesia induction. Both groups were followed up post operatively for 23 hours. In Group A maximum analgesic period was 8.30 hours and minimum analgesic period was 5.30 hours. On the other hand in Group B maximum analgesic period was 6.50 hours and minimum analgesic period was 4.50 hours. Duration of post operative analgesia between two groups of the patients were significant [p<0.01]. Post incisional wound infiltration with levobupivacain has significantly better efficacy to rectal administration of paracetamol with respect to providing pain relief following inguinal hernia repair in children. Longer duration of analgesic action is more achieved in the Levobupivacaine group. Source

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