Endoscopic Transnasal Repair of Cerebrospinal Fluid Leakage: Experience in BSMMU.

Endoscopic transnasal repair of CSF rhinorrhoea is gaining popularity around the world because of its tremendous success rate but it depends on defect site, size, technique of repair, experiences of surgeon and also patient's profile. Aim of this study was to analysis of surgical outcome of endoscopic transnasal repair of CSF rhinorrhoea. A retrospective study carried out in the department of ENT and Head neck surgery at Bangabandhu Sheikh Mujib Medical University (BSMMU) from January 2018 to December 2019. Of the total of 24 patients 16(66.0%) were female and 8(33.0%) males. The commonest site of the leak was in the cribriform plate in 18(75.3%) followed by 5(20.8%) in the fovea ethmoidalis, and 1(4.0%) in the sphenoid sinus, the overall success rate of this series with first surgical procedure was 95.83% and 100.0% with a second procedure. Meticulous pre-operative evaluation, proper identification of leakage site, choice of graft materials and surgical technique are keys to attaining excellent results.

Need Assessment for Updating the MBBS Curriculum 2012 of Bangladesh.

Curriculum is the road map of any course and an instrument for developing the competencies of the human resources. The MBBS curriculum in our country was last updated in 2012 during the period of Millennium Development Goals (MDGs). Since then it has been under implementation in different government, non-government and Army medical colleges in association with different universities. "Health Professional for a New Century" now asks for a transformation of the education to strengthen the health systems for meeting the challenges of the 21st century. Curriculum reform is an important issue in transformative education and need assessment is the first and essential task to review and update any curriculum. The objective of the study was to assess the need to review and update the MBBS curriculum 2012 of Bangladesh. Review and updating of MBBS curriculum was organized by Centre for Medical Education (CME) and supported by World Health Organization (WHO). CME, DGHS, Dean offices, MOH&FW, BM&DC and all the government and non-government medical colleges were involved in this activity. Duration of study was 7 months from April 2019 to October 2019. Data were collected from academic councils of 102 medical colleges through structured questionnaire and through FGD with teachers and interns. Around 90(88.2%) academic councils agreed and 12(12%) disagreed about the appropriateness of existing four phases of MBBS curriculum. About 80(84.2%) academic councils agreed with 1.5 years duration of Phase I, 84(88.4%) agreed with one year duration of Phase II, 84(94.4%) agreed with one year duration of Phase III and 77(84.6%) agreed with 1.5 years duration of Phase IV. The study suggested the subjects for 2nd phase are, Pharmacology 74(84.1%), Pathology 53(60.3%), Forensic Medicine 46(52.3%), and for 3rd phase are Community Medicine 60(69.8%), Microbiology 54(62.8%). The study revealed that the subjects of overloaded contents are, Anatomy - 24(50%), Community Medicine - 35(72.9%) and Pathology - 19(39.6%). The study suggested incorporation of organized teaching-learning for behavioral science, communication skills, ethics and development of attitude by most of the academic councils. The study suggested that the increased duration of ambulatory care (outdoor/emergency) teaching. The study revealed around 84(83.2%) academic councils recommended that Single Best Answer (SBA) type of questions should be included in MCQ part for all subjects along with multiple true-false response and around 82(81.2%) academic councils recommended that Structured Essay Question (SEQ) should be included in written part along with Short Answer Question (SAQ). The study revealed that 58(58.6%) academic councils recommended that carry-on system should not be in Phase I and 53(53.5%) academic councils opined to introduce grading system in MBBS course. Most of the academic councils agreed about the appropriateness of existing four phases of MBBS curriculum. The subjects for 2nd phase are, Pharmacology - 84.1%, Pathology - 60.3%, Forensic Medicine - 52.3%, and for 3rd phase are Community Medicine - 69.8%, Microbiology - 62.8%. Most of the participants are in favour of the present curriculum components, grading system for assessment but not the carry-on system in Phase I. The study recommended for national level consultations involving the concerned persons for finalization of the MBBS curriculum.

Pattern of cancer in young adults at National Institute of Cancer Research and Hospital (NICRH), Bangladesh.

This is an analysis of 1624 young adults (20-44 years) new cancer patients who attended Out Patient Department of NICRH in 2005 from 01 January to 31 December. This study was carried out to know the age and sex distribution and types of cancer they are suffering from. Histologiacally or cytologically confirmed patients or those patients having radiological or clinical evidence of malignancy were included in the study. There were 42.9% male and 57.1% female with male to female ratio of 0.75: 1.00. Female populations of this age group were the most cancer sufferers. Mean age of young adults was 34.47 (SD+/-6.33) years. Muslims (93.4%) were in majority and 36.5% were illiterate. This study revealed that the top five cancers found in both sexes were breast cancer (19.2%), female genital organ cancer (17.7%), GIT cancer (13.5%), head & neck cancer (12.2%) and respiratory tract cancer (7.9%). Breast cancer and GIT cancer ranked top among females and males respectively.