RESUMEN
Colon is one of the most commonly injured viscera followed by small gut and liver in abdomen for which management becomes complicated had the type and severity of injury not been assessed properly. With improved facilities in patient care and proper use of antibiotics the inclination is directed towards primary repair of colon without diversion. This study was aimed to assess the efficacy of primary repair in a tertiary hospital. A number of 50 patients of traumatic gut injury from 15-50 years (31.18 ± 9.38 years) mainly presenting with RTA with blunt trauma abdomen (54.0%) and different types of stab injury (40.0%) were managed with primary repair in the department of casualty in Dhaka Medical College Hospital, Dhaka between the period of January to June 2009. On admission more than half (52.0%) had hypotension, 70.0% distended abdomen, 84.0% tender abdomen, 58.0% presented with abdominal rigidity while 80% of them had perforation of the small and 20% had the same in large gut. After primary repair, only 6% developed chest infection and 4% developed wound infection. The findings suggest that primary repair without diversion in the treatment of traumatic gut injury can be performed among patients admitted in our hospitals.
RESUMEN
Advanced abdominal pregnancy (AAP) with a viable full-term fetus is a rarity that a few obstetricians encounter during their professional carrier. Usually it has a dramatic and catastrophic consequence both for the fetus & the mother; rather subsequent delivery of a viable full term fetus is exceptional. It is difficult to diagnose preoperatively. Though relatively rare, we received an AAP at term with live fetus in Faridpur Medical College & hospital. Illiteracy, poverty and lack of antenatal care had resulted in her late presentation. After laparotomy the diagnosis was confirmed, a healthy male baby was delivered.
RESUMEN
Road traffic accidents in Bangladesh have been rapidly increasing with huge mortality through road accidents each year. There are many causes of road accidents in recent years; one important cause is running of locally made improvised three wheelers (flat bed tricycle) in the urban areas and also on the highways, popularly known as 'Nasimon' and 'Karimon'. This prospective study was carried out in Faridpur Medical College Hospital from January through June 2011, to study the accident patients caused by 'Nasimon' and 'Karimon'. Fifty six (12%) patients were of RTA by 'Nasimon' and 'Karimon' out of a total of 468 patients admitted into our hospital during this period. Most patients (41, 73.21%) were male, highest accidents (24, 42.86%) were observed among 21-30 years age group and most victims (33, 58.93%) were belonged to low socioeconomic status. Commonest (31, 55.36%) victims were passengers of 'Nasimon' and 'Karimon' while maximum number of accidents (46, 82.14%) took place in the urban areas and on the highways. Injury pattern of victims were similar to that found in any other road accident patients. These three wheelers 'Nasimon' and 'Karimon' are run in violating of Bangladesh Motor Vehicles Act (1983) as they are totally unfit for plying on the highways. Strict surveillance against these illegal and risky vehicles on the highways and in the urban areas by law enforcing agencies is required as a measure to reduce the burden of road accidents in our country.
RESUMEN
Proximal hypospadias with chordee usually requires two stage procedures: 1st stage is orthoplasty and ventral parking of prepucial skin and 2nd stage is urethroplasty after 6 months of 1st stage. The aim of this study is to describe and report the outcome of a single stage repair- Koyanagi Nanamura procedure for proximal hypospadias with chordee. Between January 2006 to December 2010, 44 boys with proximal hypospadias underwent repair using the Koyanagi Nanamura technique in Paediatric Surgery Department of Faridpur Medical College Hospital and Dhaka Medical College Hospital. The boys' age ranged from 1 to 7 years. The technique employs the use of lateral penile skin and extends into the inner preputial skin. This flap enjoys double blood supply from the base of the meatus as well as the preputial vessels. Follow-up period was 6 months. Satisfactory results were obtained in 39 (88.6%) patients. Three patients developed fistulae. Two patients developed meatal stenosis. Results were considered satisfactory when the boy achieves a glanular meatus, single forward stream, unimpeded voiding, good cosmesis, and no need for secondary surgery for the urethra. Koyanagi Nanamura procedure is a reliable procedure in which the lateral flaps have dual blood supply, which produces good results (88.6%) and is suitable for proximal forms of hypospadias with chordee.
RESUMEN
A study was conducted on 131 cases of oral cavity cancer (OCC), 145 cases of oral leucoplakia and 704 subjects without any oral lesions to investigate risk factors associated with the development of carcinoma of oral cavity in a hospital based cancer registry. Personal interviews, as well as physical examinations of the subjects enabled evaluation of a variety of potential risk factors. Potential risk factors like tobacco chewing, tobacco smoking, snuff dipping, alcohol consumption, bad oral and dental hygiene and age were given each certain numerical values. Each subject was first given a scoring and then analysed and correlated with the presenting lesions, when present. The study revealed that tobacco chewing and bad oral and dental hygiene contributed mainly to higher scoring. Among the subjects in high risk group (scoring more than 400) 63% had OCC, 21% had oral leucoplakia and 16% had no clinical oral lesions. Among the medium risk group (scoring between 100 and 400) 6% had OCC, 21% had leucoplakia and 73% had no oral lesions. In low risk group (scoring below 100) 8% had leucoplakia and 92% had no clinical oral lesions. Using the scoring system, it is suggested that the high risk group for OCC could be identified from general population and cancer detection tests could be specially directed towards this target group to detect maximum number of cases with minimum possible resources.