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Khair M.A.,Mymensingh Medical College Hospital MMCH
Mymensingh medical journal : MMJ | Year: 2013

Gastrojejunostomy is one of the most important procedures in gastric cancer surgery. Anastomosis between different parts of the stomach and the intestine is a basic technical component in all gastrointestinal procedure. This study evaluated complications of gastrojejunostomy in gastric cancer surgery with two methods: single-layer and double-layer anastomosis. This study was carried out in the Department of Surgery in Mymensingh Medical College Hospital from January 1st 2010 to June 30th 2012. Fifty patients with carcinoma stomach who needed gastrojejunostomy were included in this study. These patients with average age of 43.22 years were divided in two groups (25 in each group); single-layer and double-layer anastomosis. In single-layer anastomosis gastrojejunostomy was performed in interrupted method with absorbable suture (3/0 vicryl). Double-layer anastomosis was carried out with continuous suture (2/0 silk, 2/0 catgut). Possible post-operative complications like anastomotic leakage, pelvic abscess, abdominal sepsis, anastomotic stenosis and wound infection were evaluated. In the single-layer group, 2 patient (4%) developed anastomotic leakage, wound infection and only 1 patient (2%) developed abdominal sepsis, pelvic abscess and anastomotic bleeding. No patient developed anastomotic stricture. In double-layer group, no patient developed anastomotic leakage but wound infection only in 1 patient (2%). Gastrojejunostomy with single-layer hand-sewn suture technique is safe without serious complications in comparison to double-layer suture technique. More-over operation time is less and cost is less in single-layer method.

Islam M.S.,Mymensingh Medical College Hospital MMCH
Mymensingh medical journal : MMJ | Year: 2013

Lumber spinal canal stenosis is an important cause of low back pain and it frequently presents with low backache with neurogenic claudication. Operative management of lumbar spinal canal stenosis by decompression surgery is an effective method. This prospective interventional (quasi experimental) study was performed in patient having history of characteristic clinical features like low backache with radicular pain, neurogenic claudication, signs of root compression, positive MRI findings attending in the department of Orthopaedic Surgery and Neurosurgery, Dhaka Medical College Hospital and NITOR. Dhaka, from July 2008 to June 2010. Thirty patients were evaluated among those 18(60%) were 50 years and above. Male to female ratio was roughly 9:1. About 87% of the patients had sensory deficit and 50% had neurogenic claudication. Majority (83.3%) of the patients at presentation had a suffering of 12 or >12 months. Diagnosis shows that 3.5% of patients had L4 lesion, 60% L5, 6.5% patients had L4 & L5 and 30% S1. Laminectomy was done in 43.3% of patients, laminectomy and disectomy in 30% and laminectomy, discectomy & foraminal decompression in 26.7% of patients. Relief of symptoms occurred in 25(83.5%) of patients. Over three-quarter (76.7%) of patients exhibited minimal disability and 23.3% moderate disability based on Oswestry Disability Index, while by MacNab criteria, most (80%) of patients was excellent, 10% good and another 10% fair. Repeated measure ANOVA statistics showed that mean Oswestry score decreased significantly from 54.5% at baseline to 22% at the end of 1 year (p<0.001).

Hasan M.M.,Mymensingh Medical College Hospital MMCH
Mymensingh medical journal : MMJ | Year: 2013

The school age is a dynamic period of growth and development. During this period physical, mental, social development of child takes place. The purpose of the study is to observe the nutritional status among the school aged children and to compare the urban and rural children. It is a descriptive cross sectional study. Data were collected from 600 children of primary school in Mymensingh district for a period of one year from October 2009 to September 2010. Among the primary school children in Mymensingh, Bangladesh 15.1% were wasted, 22.1% were stunted, 2.3% were both stunted and wasted and 60.4% children were within normal limit. Malnutrition was more in rural area in comparison with urban area. In rural area severely underweight, moderately underweight children were 62.1%, 65.6%, and corresponding result in urban area were 37.9%, 34.4% respectively. In rural area severely stunted, moderately stunted children were 100%, 58.6%, and in urban area they were 0%, 41.4% respectively. Again severely wasted and moderately wasted, children were 62.5%, 59.5% in rural area and 37.5%, 40.5% in urban area respectively. Malnutrition among girls were more then the boys.

Chakrabarty P.,Mymensingh Medical College Hospital MMCH
Mymensingh medical journal : MMJ | Year: 2014

Though regular blood transfusion improves the overall survival of patients with β-thalassemia which is one of the most common genetic diseases in the world, carries a definite risk of infection with blood-borne viruses. World Health Organization (WHO) reported that there is about 3% beta thalassemia carrier and more than two thousand thalassemic children are born every year in Bangladesh. Master Akib of age 15 years was the known case of Beta Thalassemia taking blood from his 3rd Birth Day from Mymensingh Combined Military Hospital, Bangladesh. Day care centre of Transfusion Medicine Department of Mymensingh Medical College Hospital started HBV, HCV, HIV screening of Thalassemic patient from 1st July, 2012. After screening of his blood, we found his blood contains HCV which is 3-4 times repeated positive with three other companies' reagent (rapid immuno-chromatographic assay) and result is confirmed. His treatment started and continues for 24 weeks and after 24 weeks, to monitor treatment response, his blood again test for Serum HCV-RNA which was not detected. Now Master Akib free from HCV infection and HCV diagnose accidentally because it remain silent for long time. We recommend that in public sector hospitals and health care units ELISA should be preferred for anti-HCV detection over ICT.

Dey P.K.,Mymensingh Medical College Hospital MMCH
Mymensingh medical journal : MMJ | Year: 2013

This case control study was carried out in Mymensingh Medical College Hospital, Mymensingh, Bangladesh and Dhaka Medical College Hospital, Dhaka, Bangladesh from November 2010 to October 2011 to find out the risk factors of non-alcoholic fatty liver disease. A total of 90 participants (45 cases and 45 controls) were included. A higher proportion of patients with age >45 years were found in case group compared to control (51.1% vs. 15.6%). The mean age was significantly higher in case group 49.8±12.6 years. Males demonstrated their predominance in both case (62.2%) and control (68.9%) groups, although the two groups did not differ in terms of sex distribution. Body mass index demonstrates that 26.7% of patients in case group were of normal weight, 46.7% overweight and 26.7% obese. In the control group, two-thirds (68.9%) of the patients were of normal weight and 24.4% overweight and 7.8% obese. Diabetes and hypertension were significantly present in the case group than those in control counterparts 75.6% vs. 15.6% and 86.7% vs. 15.6 % respectively. The mean fasting blood glucose, ALT, total cholesterol and triglycerides were significantly higher in case group compared to control group 7.8±1.3 vs. 5.4±2.5mmol/L (p<0.001); 39.1±12.4 vs. 30.3±14.1IU/L, (p=0.002); 239.9±14.3 vs. 183.3±11.4mg/dl, (p<0.001) and 183.6±12.5 vs. 133.5±16.0mg/dl, (p<0.001) respectively. However, no significant difference was observed between the case and the control groups in terms of HDL cholesterol (35.9±1.2 vs. 38.0±1.1mg/dl, p=0.203). Majority of the patients in case group (88.9%) exhibited increased echogenicity of liver on ultrasonogram as opposed to 15.6% in the control group.

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