Parathyroid failure following thyroid surgery.

This cross-sectional study was done to see the association of post thyroidectomy parathyroid failure with thyroid disease and type of surgery. It was carried out in the Department of Otolaryngology-Head and Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka during the period of July 2008 to June 2010. Total 50 cases of thyroid malignancy and multinodular goiter who had undergone total or near total thyroidectomy with or without neck dissection were studied. In this study highest number of cases were found in 3rd decade of age (28%) and there was female predominance (M:F=1:3.54). Overall frequency of post operative hypocalcaemia was 30% (26% was temporary hypocalcaemia and 4% was permanent). Hypocalcaemia revealed clinically in 20% cases and remained subclinical in 10% cases. Hypocalcaemia developed in 42.30% cases of malignant thyroid disease and 16.66% cases of benign thyroid disease (p<0.05). It was found in 54.54% cases with neck dissection and 23.07% cases without neck dissection (p<0.05). Hypocalcaemia developed in 62.5% cases where parathyroid gland were not identified and 23.8% cases where parathyroid gland was identified. Hypocalcaemia developed most commonly on the 2nd post operative day (73.33%). There is a significance difference with development of parathyroid failure after thyroid surgery between benign and malignant thyroid disease and also between thyroid surgery with or without neck dissection.

A comparative study among laparoscopically assisted vaginal hysterectomy, vaginal hysterectomy and abdominal hysterectomy: experience in a tertiary care hospital in Bangladesh.

The study was undertaken to compare the efficiency and outcome of laparoscopically assisted vaginal hysterectomy (LAVH), total abdominal hysterectomy (TAH) and vaginal hysterectomy (VH) in terms of operative time, cost, estimated blood loss, hospital stay, quantity of analgesia use, intra- and postoperative complications rate and patients recovery. A total of 750 patients were prospectively collected in the study period from January 2005 through January 2009 in a tertiary care hospital. The mean estimated blood loss in LAVH and VH group were significantly lower compared with the TAH group. As to postoperative pain, significantly less diclofenac was required in the LAVH and VH group vs the TAH group. LAVH, VH is clinically and economically comparable with TAH, with patients' benefits of less estimated blood loss; less analgesia use; less intra- and postoperative complication rates; less postoperative pain; rapid patient recovery and shorter hospital stay. The study concludes that thus, LAVH, VH is clinically and economically comparable with TAH.

Evaluation of the results of posterior decompression, posterolateral fusion and stabilization by pedicle screw and rod in traumatic thoracolumbar fractures.

This study is to evaluate the clinical and radiological success of posterior decompression, posterolateral fusion and stabilization by pedicle screw and rod in the management of traumatic thoracolumbar fractures. It is a prospective interventional study which is carried out in Bangabandhu Sheikh Mujib Medical University and different private hospitals in Dhaka city from January 2008 to December 2010. Total 16 patients were selected according to the inclusion and exclusion criteria. There were 10 male patients and 06 female within a age range of 21-40 years. Mean age was 33.32 years. Total 08 cases involved L1, 03 cases involved at D12, 02 cases involved at D1, and at L2 each whereas 01 case at L3. Total 10 cases were of compression fracture and remainder 06 burst fractures. Ten (10) patients presented with paraparesis, 05 patients with incomplete paraplegia and 01 patient with complete paraplegia. All the patients were followed up for minimum 1 year. Patients with paraparesis fully recovered neurologically and could walk without support. All the 05 patients with incomplete paraplegia also recovered fully except 01 which gained partial improvement and walks with aids. One patient with complete paraplegia remained unchanged. Our results show that posterior decompression posterolateral fusion and stabilization by pedicle screw and rod provides a safe and effective surgical option for management of traumatic thoracolumbar fractures.