Unmet Need for Family Planning among Married Women: Experience from Rural and Urban Communities.

Unmet need for family planning is the key indicator to achieve Millennium Development Goal by the year 2015. Bangladesh Government has a great success in family planning sector but population has almost doubled in recent years. This study was carried out among married women to compare the determinants of unmet need for family planning among rural and urban communities during the period from July 2010 to June 2011. Unmet need for family planning in rural community was found 18(12%) and in urban community it was 38(25.3%). Among rural women unmet need for limiter was 13(8.6%) and spacer was 5(3.4%) while limiter 29(19.4%) and spacer 9(5.9%) found among urban women. Mean age at marriage was found 17.97(SD±2.66) years and mean age at first child birth was 19.91(SD±2.71) years among rural women. Among urban women mean age at marriage was found 20.43(SD±4.08) years and mean age at first child birth was 22.55(SD±4.3) years. Current contraceptive users among rural women was 79(52.7%) while it was 61(40.7%) among urban women. In this study, association between unmet need for family planning and freedom of choice of contraceptives was highly significant (p=0.001). To increase contraceptive prevalence rate and reduction of unplanned pregnancy, more emphasis should be given on unmet need for family planning.

Left Atrial Myxoma in a Child: An Uncommon Presentation of a Rare Tumour in Early Age.

Myxomas are rare tumours but are the most common benign tumours of the heart. They can arise from any heart chamber. However, they arise more frequently from the left atrium. They have rarely been described as originating in early age. A case of left atrial myxoma successfully removed using cardiopulmonary bypass in a 8-year-old child is presented. Review of the literature emphasizes the rarity and clinically aggressive behavior of this tumor in this age group. The object of this case report is to present myxoma in children and to evaluate possible differences between young and adult patients.

Left Atrial Myxoma in a Child: An Uncommon Presentation of a Rare Tumour in Early Age.

Myxomas are rare tumours but are the most common benign tumours of the heart. They can arise from any heart chamber. However, they arise more frequently from the left atrium. They have rarely been described as originating in early age. A case of left atrial myxoma successfully removed using cardiopulmonary bypass in a 8-year-old child is presented. Review of the literature emphasizes the rarity and clinically aggressive behavior of this tumor in this age group. The object of this case report is to present myxoma in children and to evaluate possible differences between young and adult patients.

Off Pump Complete Revascularization Through Left Lateral Thoracotomy (ThoraCAB): NICVD Experience.

Background: Conventional coronary artery bypass surgery (CABG) is associated with substantial morbidity caused by cardiopulmonary bypass (CPB) and median sternotomy. Here we described an innovative technique to perform complete revascularization through a left lateral thoracotomy without CPB (ThoraCAB). Methods: From September 2005 to December 2008 a total 83 patients underwent ThoraCAB in National Institute of Cardio Vascular Diseases (NICVD). The patient is positioned with the left side elevated to 45 degree. A 6 to 8 inches long incision is made over the left 4th or 5th intercostal space from just medial to the nipple to the anterior axillary line. The left internal mammary artery (LIMA) is harvested as a pedicle graft under vision. Distal coronary anastomosis is completed first on the beating heart using a stabilizer, followed by proximal anastomoses on the descending aorta. Peroperative and postoperative complication the arrhythmia hypotension wound infection death was observed. Results: Complete revascularization was achieved in all patients. The number of grafts averaged 2.18±1.08 per patients. One patient died (1.2%) due to severe respiratory acidosis. One patient (1.2%) was converted to CPB due to arrhythmia. No strokes were observed. Of these patients, 7.2% developed new onset postoperative atrial fibrillation. Conclusion: ThoraCAB has been feasible in the vast majority of the patients requiring CABG surgery. The prevalence of the post operative atrial fibrillation was low. Left lateral thoracotomy offers an attractive and effective alteration to Off Pump median sternotomy.

Sarcomatoid renal cell carcinoma with huge retroperitoneal metastasis.

Sarcomatoid Renal Cell Carcinoma (SRC) is a very rare form of renal neoplasm with very poor prognosis. A case of sarcomatoid renal cell carcinoma (SRC) is reported herein at the National Institute of Kidney Diseases and Urology (NIKDU), Dhaka. A 40 year old man presented with swelling in right loin with dragging abdominal pain and intermittent low grade fever. A huge, fleshy and highly vascular retroperitoneal mass was found peroperatively. Tumor affected the lower pole of right kidney invading the renal capsule, perinephric fat and continued to grow as a large tumor mass in the right retroperitoneal space Histologically, it revealed the features of sarcomatoid renal cell carcinoma.

Prevalence of chronic suppurative otitis media among the children living in two selected slums of Dhaka City.

Chronic Suppurative Otitis Media (CSOM) is one of the important health problems in our country. Serious complications may arise from it. As such the study was aimed to find out the prevalence of CSOM among the children of two-selected slum dwellers in Dhaka City. This was a descriptive type of cross-sectional study. A total of 203 samples were interviewed and examined. Altogether 7.39% of children were observed to have CSOM. Among CSOM cases, 60% had hearing impairment. Ear discharge and perforation were observed in 26.7% in right ear, 46.7% in left ear and 26.7% in both ears. Central perforation was present in 93% cases. Cholesteatoma was present in 6.7% cases. Among CSOM cases, 53.3% children were in 2-5 years age group, 80% were dependent, 53.3% cleaned ear by cotton buds, 93.3% lived in Kutcha house, 73.3% had a monthly income of TK. 1001-2000 and 46.7% belonged to families having 6 members. Out of 15 CSOM, 11 cases were seen among children of 141 illiterate mothers. Four cases of CSOM were found among children of 62 literate mothers. Among the 203 mothers, 65.52% were found aware, and 34.48% were not aware about the disease and sequel of CSOM. Here 39.9% mothers had knowledge and 60.01% had no knowledge about the treatment of CSOM. Among the CSOM cases 46.67% cases did not receive any treatment. In treatment receiving group, only 3(20%) children received it from MBBS doctor or Hospital.