Mymensingh medical journal : MMJ
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Case Reports
Back pain and vertebral compression: an unusual presentation of childhood acute lymphoblastic leukemia.
Junayet, a nine years and six months old boy was admitted to the hospital because of back pain and vertebral compression fractures. The boy had been well until two months earlier, when he began to have back pain after falling on his back along with occasional fever. The pain was intermittent initially but gradually it became constant. ⋯ Then, he was started protocol based chemotherapy for induction of remission, consolidation, high dose methotrexate and maintenance therapy. Now, he is on regular follow up with repeated hematological and radiological examinations. Following six month of chemotherapy the boy was found with significant improvement of his physical, hematological and radiological abnormalities.
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Randomized Controlled Trial
Effects of therapeutic modalities on patients with post stroke shoulder pain.
A randomized clinical trial was conducted to find out the effects of physical modalities transcutaneous electrical nerve stimulation (TENS) and ultrasonic therapy (UST) on the patients with post stroke shoulder pain in the Department of Physical Medicine & Rehabilitation & Department of Neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU) from 1st July 2006 to 31st December 2006. In that period a total of 750 stroke patients attended the stroke clinic of the Department of Neurology, BSMMU, of which 150(20%) patients presented with post stroke shoulder pain. Among the patients with post stroke shoulder pain, 45(6%) patients were included in the study. ⋯ Significant improvement was observed after treatment in each group except in active internal rotation in UST group. But in comparison between two groups, Group A (TENS) showed statistically significant better improvement in all planes of pain free range of motion than Group B except active abduction which was better improved in group B (UST) and in case of passive abduction, passive external rotation and passive extension, TENS had better effect than UST. It may be concluded that TENS and UST both are effective but TENS may be safer and superior to ultrasonic therapy (UST) in the treatment of the patients with post stroke shoulder pain.
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Anaesthesia for parturient patients with dwarfism is an uncommon problem faced by anaesthesiologists. There is an ongoing debate regarding general versus regional anaesthesia in these cases. In many centers there is lack of facilities for epidural or continuous epidural anaesthesia. ⋯ We have managed the case by sub-arachnoid block (SAB) using 7.5 mg (1.5 ml) of 0.5% heavy bupivacaine at a level of L3-L4 interspace having adequate level of block and analgesia. The case was managed successfully and uneventfully. In this presentation, the role of SAB and a management guideline has been highlighted.
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Randomized Controlled Trial Comparative Study
Comparative efficacy of combined nebulized salbutamol with ipratropium bromide and nebulized adrenaline to treat children with acute bronchiolitis.
As the efficacy of combined nebulized salbutamol & ipratropium bromide as well as L-adrenaline to treat acute bronchiolitis is not well studied among the Bangladeshi infants, this study was carried out to see their efficacy in acute bronchiolitis and to compare their effectiveness. This randomized clinical trial was done among 60 children aged less than 02 years, admitted in the department of Pediatrics, Dhaka Medical College Hospital, during January through December 2005 with acute bronchiolitis. After a quick initial assessment, nebulization were done twice at 6 hours interval with the mentioned drugs, group wise (one group with salbutamol plus ipratropium bromide and other group with L-adrenaline alone) and the outcomes were assessed after 30 minutes of each nebulization in respect to oxygen saturation and clinical modified respiratory distress assessment instrument (MRDAI) scores. ⋯ However, L-adrenaline showed more efficacy (MRDAI, p=0.021; SaO2, p=0.034) than combined Salbutamol & Ipratropium bromide. Both L-adrenaline and combined salbutamol & ipratropium bromide were found effective in acute bronchiolitis but L-adrenaline was found more effective. A large multi-centre clinical trial is recommended.
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In terms of mortality and morbidity, childhood burn comprises a significant public health problem in Bangladesh, especially in rural poor families who use kerosene-lamp "Kupi" for lighting and traditional mud-made open oven for cooking. They lack optimum safety measures. A total of 100 patients in the age group of 01 to 15 years who got admitted into the burn unit of Dhaka Medical College Hospital during the first half of 2005 were enrolled in the study. ⋯ There were 02 deaths in the series; both were females and were the victims of massive flame burn-one from Kupi and other form oven fire during cooking. Pediatric burn imposes stress on the physique, psyche and socio-economic status of the affected personnel and families. Effective measures are needed to prevent this unfortunate injury in children which is preventable to a large extent.