scholarly journals Microtia reconstruction: our experiences of first 10 cases in Bangladesh

1970 ◽  
Vol 1 (2) ◽  
pp. 14-19
Author(s):  
MS Khondoker ◽  
R Awwal ◽  
MM Sarker ◽  
SH Khundkar

Varying degrees of congenital ear deformity (microtia) occurs 1 in about 8000 to 10,000 live births. One of the greatest challenges in plastic surgery is total auricular reconstruction as it demands precise technique as well as artistic creativity. In Bangladesh, recent advancement in the technique of carving and sculpting rib cartilage  and better training for achieving finer anatomic details has given a break through in the surgical management of  deformed ear. Between January 2009 and January 2010, total ear reconstruction was done with a two-stage method using  autogenous costal cartilage in the Department of Plastic Surgery, Dhaka Medical College Hospital, Dhaka. In the first stage, lobule rotation, fabrication of the cartilage framework and its implantation were performed. In  the second stage, elevation of the auricle and formation of the tragus were done. A total of 10 cases with microtia comprising different age group have been operated. All of them underwent stage I operation; among them 8 patients went through stage II procedure while the other 2 are waiting for the same. Results: 10 patients, ranging in age between 8 and 25 years, were operated on using autogenous costal cartilage between 2009 and 2010. Six patients were males and four were females. Unilateral microtia was present in all of these patients (7 right, 3 left). Eight cases were with Grade III microtia; the remaining 2 cases presented with Grade II microtia. The follow-up period was one month to one year. Seven among 8 cases presented acceptable ear contour after second stage ear reconstruction. The cranioauricular angle of the reconstructed ears was also similar to that of the opposite ears. Unfavourable result was deformation of the constructed helix which occurred in one case. Though it is impossible to reconstruct an ear that appears exactly as the opposite one, the new ears which were  made were of correct size and in normal position with impressive finer three dimensional details that achieved patient’s satisfaction as well as surgeon’s professional gratification.Key words: Microtia; Two stage auricular reconstruction; Autologous costochondral cartilageBDJPS 2010; 1(2): 14-19

2014 ◽  
Vol 3 (2) ◽  
pp. 49-52 ◽  
Author(s):  
Md Zakir Hossain ◽  
Bidhan Sarker ◽  
Lutfar Kader Lenin ◽  
Ayesha Hanna ◽  
Limon Kumar Dhar

Background: Scalp reconstruction following high voltage electric burn can be challenging. A useful Reconstructive algorithm is lacking. The purpose of this study was to evaluate our experience and to identify an appropriate reconstructive strategy. Methodology: This was a prospective observational study, conducted in the Burn unit of Dhaka Medical College Hospital & Department of Burn & Plastic Surgery,Sir Salimullah Medical College & Mitford Hospital over a period of five years. Reconstructive procedures, independent factors and outcomes were evaluated. A total of 7 procedures were performed in 30 patients. Techniques for reconstruction included skin grafting, outer table drilling & skin grafting, Bipedicle flap, Single rotation flap, Double opposing rotation flap, Transposition flap, Tissue expansion & primary closure. Conclusion: Important tenets for successful management of scalp defects are durable coverage, adequate debridement, preservation of blood supply, and proper wound drainage. Local scalp flaps with skin grafts remain the mainstay of reconstruction in most instances. DOI: http://dx.doi.org/10.3329/bdjps.v3i2.18251 Bangladesh Journal of Plastic Surgery July 2012, 3(2): 49-52


2019 ◽  
Vol 19 (1) ◽  
pp. 26-35 ◽  
Author(s):  
Xuan Luo ◽  
Gaoming Jiang ◽  
Honglian Cong

Abstract This paper focuses on the better performance between the garment simulation result and the simulation speed. For simplicity and clarity, a notation “PART” is defined to indicate the areas between the garment and the human body satisfying some constraints. The discrete mechanical model can be achieved by the two-stage process. In the first stage, the garment can be divided into several PARTs constrained by the distance. In the second stage, the mechanical model of each PART is formulated with a mathematical expression. Thus, the mechanical model of the garment can be obtained. Through changing the constrained distance, the simulation result and the simulation speed can be observed. From the variable distance, a desired value can be chosen for an optimal value. The results of simulations and experiments demonstrate that the better performance can be achieved at a higher speed by saving runtime with the acceptable simulation results and the efficiency of the proposed scheme can be verified as well.


Author(s):  
Shanmugapriya Kumaresan ◽  
Malarvizhi Loganathan

Background: There is an alarming rise in caesarean section leading to increased adverse outcomes for both the mother and fetus when compared with vaginal delivery. With this increasing caesarean section rate, there is a concerning increase in the rate of second stage caesarean section. This study highlights includes the rate of caesarean deliveries in the second stage of labour, the indications for delivery and the associated maternal morbidity in this cohort of women.  Methods: This was a prospective cohort review of all women with a singleton, cephalic fetus at term delivered by caesarean section in the second stage of labor between July, 2016 and December 31, 2017 at government medical college hospital Dharmapuri. The main outcome measures were second stage caesarean section, indications and its maternal morbidity.Results: 250 women underwent caesarean delivery in the advanced labor. Among the 250 patient’s majority of them were in the age group of 21-30 yrs. about 76% of the patients were primigravidae and only the remaining 24% were multigravida. The commonest indications for doing caesarean section in the second stage of labor was cephalo pelvic disproportion and non-reassuring fetal heart rate patterns. The difficult task was delivery of the deeply engaged head, the increased likelihood of intraoperative and post-operative complications.Conclusions: Cesarean sections done in second stage of labor are associated with several intra-operative maternal complications and morbidity.


2012 ◽  
Vol 1 (2) ◽  
pp. 2-5
Author(s):  
Abdul Matin ◽  
Md Rafiqul Islam ◽  
Ranjit Ranjan Roy ◽  
Bijoy Krishna Das ◽  
Sudesh Chandra Rakshit ◽  
...  

Background and study aim: Torticollis is the postural deformity of head and neck. Congenital Muscular Torticollis (CMT) is a postural deformity of head and neck detected at birth or shortly after birth, primarily resulting from unilateral shortening of Sternocleidomastoid muscle (SCM), In neonates and infants, patient may cure conservatively by physiotherapy but surgery is the treatment of choice for children and adolescents. Here we show our experience regarding management of congenital muscular torticollis with physiotherapy. Patients and Methods: This is an observational descriptive study. Verbal consent from parents was taken. Patients of congenital muscular torticollis with other disease or other congenital anomaly were excluded from study. Twenty patients of congenital muscular torticollis were treated. The cases were enrolled between Nov' 2005 to Oct' 2008 in Bangabandhu Sheikh Mujib Medical University, Gonosasthaya Somaj Vittik Medical College Hospital, ZH Sikder Women's Medical College Hospital, Shaheed Shurawardy Medical College Hospital. Neonates and infants were treated conservatively with physiotherapy and non responsive cases were referred for surgery. Results: Patients age range from 5 days to 1 year of which eleven were females and nine were males. Sternocleidomastoid muscle (SCM) was shortened in all cases (12 on right side and 8 on left side). Of 20 patients 6 neonates, rest 14 infants within 1 year age. Out of 20 neonates and infants 17 were cured conservatively with physiotherapy and rest 3 were referred for surgery. Conclusion: Most of the patient of congenital muscular torticollis can be treated conservatively during infancy. DOI: http://dx.doi.org/10.3329/jssmc.v1i2.12157 Journal of Shaheed Suhrawardy Medical College Vol.1, No.2, December 2009 p.2-5


2018 ◽  
Vol 27 (1) ◽  
pp. 29-33
Author(s):  
Md Moksedur Rahman ◽  
Md Abdullah ◽  
Moriom Nessa ◽  
Muhammad Afsar Siddique ◽  
Md Moazzem Hossain ◽  
...  

Fixed drug eruption (FDE) is a distinctive type of cutaneous drug reaction that characteristically recurs in the same site or sites each time a particular drug is taken. FDEs are among the most frequent problems encountered by the dermatologists. The present study was carried out to recognize offending drugs, to educate the patients and to avoid self-administration of drugs and re-administration of the offending drugs. The study was conducted in Skin & VD outpatient department of Rajshahi Medical College Hospital, Rajshahi over a period of one year. One hundred ten cases with established FDE were evaluated clinically. The causative drugs were identified and confirmed by provocation tests. Cotrimoxazole (25%) was the most common cause of FDE. Other drugs incriminated were NSAID (21.8%), Tetracycline (15.4%), Ciprofloxacin (10%), Amoxicillin (7.2%), Metronidazole (5.4%), Griseofulvin (2.7%) and Fluconazole (1.8%). The lesions were found to be distributed on the oro-genital mucosa, trunk and the acral regions.The main presentation of FDE was circularhyperpigmented lesion.TAJ 2014; 27(1): 29-33


2016 ◽  
Vol 27 (1) ◽  
pp. 5-8 ◽  
Author(s):  
Mukti Rani Saha ◽  
Iffat Ara ◽  
Sabera Khatun ◽  
Suvash Chandra Roy ◽  
Tapan Kumer Saha

Objective: A prospective, observational study in Dhaka Medical College Hospital was carried out to assess the efficacy of loop electrosurgical excision procedure (LEEP) of the transformation zone of cervix as an outpatient procedure as diagnostic and therapeutic purpose during visit of patients with the report of CIN II or CIN III on histopathology.Method: One hundred women over a period of one year from 1st January to 31st December 2011 were treated with LEEP as an outpatient procedure. Among these women 63 patients were CIN II and 37 patients were CIN III on histopathology report. LEEP were done under local anaesthesia. All patients were followed up for one year with colposcopy and also histology where appropriate.Results: In all cases, the specimens obtained were adequate for histopathological assessment and in 98 (98%) cases the lesion had been completely excised. Two cases of CIN III required a second excision. One patient needed cervical sutures to achieve haemostasis following the excision. One patient was admitted in the hospital with primary haemorrhage. Two patients were admitted with secondary haemorrhage.Conclusion: LEEP under local anaesthesia is an effective technique. It enables the treatment of patients with cervical intraepithelial neaplasia and exclusion of invasive cancer in a subsequent visit. Thus adequate tissue is made available for accurate diagnosis, thereby improving the accuracy of treatment.Bangladesh J Obstet Gynaecol, 2012; Vol. 27(1) : 5-8


Author(s):  
Atif Ahmed ◽  
Kuldeep Poorani ◽  
Mohammad Amjad Kalhoro ◽  
Nisar Ahmed Khokar ◽  
Abdul Ghaffar Dars

Aim: To study the incidence of HbA1c elevation in patients with ischemic stroke whose blood glucose levels were normal within the last six months. Study Design: A cross-sectional study. Place and Duration: This cross-sectional study of the 96 patients with cerebral ischemic disease selected from the internal medicine department of Bilawal medical college Hospital Kotri, Sindh, Pakistan for one-year duration from August 2019 to August 2020. Methods: Crossectional study was conducted in the internal medicinal department of Bilawal Medical college Hospital, Kotri Sindh, Pakistan for the period of one year from August 2019 to August 2020. Total 96 study subjects were selected with cerebral ischemic disease, 62 were males and 34 were females. Many factors such as age more than 20 years, ischemic stroke and RBG (Random Blood Glucose) were also evaluated from each participant. SPSS 23.00 version was used for statistical analysis of research data. Results: 57.01 ± 13.4 years was the mean age of the patients. 62 (64.6%) patients were male and 34 (35.4%) were female. The male to female ratio was 2:1. HbA1c was elevated in 35 (36.5%) of 96 patients, while 61 (63.5%) had normal HbA1c.  The distribution of HbA1c elevation by gender showed that 20 (57.1%) patients with elevated HbA1c were men and 15 (42.9%) were women. Forty-three (70.5%) of 61 patients with normal HbA1c were male and 18 (29.5%) were female. Conclusion: it was concluded that glycated haemoglobin plays an important role for reducing the macro complication of Diabetes and the major macro complication observed was cerebral ischemic stroke among the people with elevated HbA1c.


2014 ◽  
Vol 15 (2) ◽  
pp. 110-113
Author(s):  
Tania Mahbub ◽  
Md. Nizamuddin Chowdhury ◽  
Ferdous Jahan ◽  
Aparna Das ◽  
Md. Motlabur Rahman ◽  
...  

Background: Worldwide haemodialysis(HD) is the mostly used method of renal replacement therapy. Arteriovenous fistula use is on rise due to Fistula First Initiative due to least complications of fistulae than catheters.But they are also subjected to many complications. Thereby appropriate surveillance of the fistulae is important.Objectives: To measure the blood flow as well as fistula related complications in study population. Materials and Methods: This was a cross sectional study, conducted in the department of Nephrology, Dhaka Medical College Hospital during September 2010 to December 2011.Total 118 subjects were included in the study. Besides visualization technique colour Doppler ultrasonogram of fistula and  echocardiography were performed for each patients. Results: Most of the patients had adequate fistula flow. Aneurysm was most common complication. Many subjects were suffered from primary and secondary fistula failure. Conclusion: Arterio-Venous fistula is subjected to many complications and appropriate surveillance should be launched to detect complications and to prevent fistula failure.DOI: http://dx.doi.org/10.3329/jom.v15i2.20681 J MEDICINE 2014; 15 : 110-113


2019 ◽  
Vol 19 (2) ◽  
pp. 52-54
Author(s):  
Noazesh Khan ◽  
Tahmina Satter

Microvascular surgery is a standard procedure in various surgical specialities. For the beginner the logical approach is to start the training with the materials like latex gloves and silastic tube, moving to animal cadaver and finally living animal. In all respect, the training in this particular speciality is costly and facilities are very limited in Bangladesh. Microsurgical training laboratory in National Institute of Burn and Plastic Surgery in Dhaka medical College Hospital conducting courses on Basic and Advanced microsurgery training since July’ 2013. In this paper we introduce the importance and low cost opportunity of training, so that skill would be mastered first in the lab and then applied in real life. Journal of Surgical Sciences (2015) Vol. 19 (2) : 52-54


Author(s):  
Aruna Rani R. ◽  
Dheeba Jayanthi R. ◽  
Eswari S.

Background: In modern obstetrics, the prevalence of Eclampsia and its complications are high, so we decided to study pregnancy outcome in all Antepartum Eclampsia patients. The present study was carried out to investigate the maternal and fetal outcome in patient with Antepartum eclampsia.Methods: A prospective study was conducted in Government Mohan Kumaramangalam Medical College Hospital, Salem, India over a period of one year from January 2016 to December 2016 in all Antepartum Eclampsia patients. Analysis was done regarding the age of women, parity, gestational age, imminent symptoms, mode of delivery, fetal outcome and maternal morbidity and mortality.Results: Incidence of Antepartum Eclampsia in our hospital is 0.7%. It is more common in age group of 20 to 25years (68.5%) and primigravida (56%) and gestational age >37 weeks (51.85%). Commonest mode of delivery was by caesarean section (72%). Out of 54 patients of Antepartum Eclampsia 3 (5.5%) died and 18 (33%) had complications. Out of 50 live babies, 16 (32%) died.Conclusions: Eclampsia is still one of the important and common obstetric emergencies and it has a significant role in maternal and fetal outcome. The early identification of risk factors and timely intervention is needed to improve maternal and perinatal outcome.


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