scholarly journals Management of Pelvic Fracture Urethral Injury- 147 Cases

KYAMC Journal ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 179-183
Author(s):  
Hafiz Al Asad ◽  
Nahid Rahman Zico ◽  
AKM Shahadat Hossain ◽  
Zulfia Zinat Chowhury ◽  
Md Mostafizur Rahman ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Pelvic Fracture ◽  
Urethral Catheter ◽  
Urethral Injury ◽  
College Hospital ◽  
Medical College ◽  
History Of ◽  
Anastomotic Urethroplasty

Background: Dhaka Medical College Hospital is the highest referral center for PFUI. As anstomotic urethroplasty is a challenging surgery and most of the surgeons refer these type of injuries to our center, we performed this study to evaluate the outcome of our cases. Objective: This study aims to find the outcome and complications of perineal end to end anastomotic urethroplasty in the management of posterior urethral injury resulting from pelvic fracture. Materials and Methods: We performed 147 perineal bulbo-prostatic anastomotic urethroplasty for PFUIs from January, 2013 to May, 2019. Mean age was 37 years with majority between 21 to 50 years (>85%). Nine patients had history of failed anastomotic urethroplasty. After surgical intervention patients were discharged with a supra-pubic catheter (SPC) and per urethral catheter in situ. On 22nd POD urethral catheter was removed and SPC on the next day if patient can void normally. 1st and 2nd follow up done on of 3rd and 6th month respectively following surgery. If patient voided well and Qmax>15ml/ sec; repair was defined as successful. Results: Success rate of anastomotic urethroplasty for PFUI was 93.87%. Total 9 procedures were failed including 2 urethro-cutaneous fistula and needed re-do anastomosis. Erectile dysfunction (ED) was present in 18 patients before operation and after surgery 12 more patients developed ED and total number was 30 during first follow up, which reduced to 24 during second follow-up. Two patient developed incontinence which improved in subsequent follow-up. Conclusion: Anastomotic urethroplasty remains the gold standard in the management of PFUI. Erectile dysfunction is the main issue to be concerned and need special attention. KYAMC Journal Vol. 10, No.-4, January 2020, Page 179-183

Outcome of Percutaneous Nephrostomy in Children With Ureteropelvic Junction Obstruction

2020 ◽  
Vol 20 (2) ◽  
pp. 61-64
Author(s):  
Mohammad Mahfuzur Rahman Chowdhury ◽  
Rifat Zaman ◽  
Md Amanur Rasul ◽  
Akm Shahadat Hossain ◽  
Shafiqul Alam Chowdhury ◽  
...  
Keyword(s):  
Renal Function ◽  
Low Dose ◽  
Ureteropelvic Junction Obstruction ◽  
Percutaneous Nephrostomy ◽  
Ureteropelvic Junction ◽  
College Hospital ◽  
Medical College ◽  
Split Renal Function

Introduction and objectives: Congenital ureteropelvic junction obstruction (UPJO) is the most common cause of hydronephrosis. Management protocols are based on the presence of symptoms and when the patient is asymptomatic the function of the affected kidney determines the line of treatment. Percutaneous nephrostomy (PCN) became a widely accepted procedure in children in the 1990s. The aim of the study was to evaluate the results of performing percutaneous nephrostomy (PCN) in all patients with UPJO and split renal function (SRF) of less than 10% in the affected kidney, because the management of such cases is still under debate. Methods:This prospective clinical trial was carried out at Dhaka Medical College Hospital from January 2014 to December 2016. Eighteen consecutive patients who underwent PCN for the treatment of unilateral UPJO were evaluated prospectively. In these children, ultrasonography was used for puncture and catheter insertion. Local anesthesia with sedation or general anesthesia was used for puncture. Pig tail catheters were employed. The PCN remained in situ for at least 4 weeks, during which patients received low-dose cephalosporin prophylaxis. Repeat renography was done after 4 weeks. When there was no significant improvement in split renal function (10% or greater) and PCN drainage (greater than 200 ml per day) then nephrectomies were performed otherwise pyeloplasties were performed. The patients were followed up after pyeloplasty with renograms at 3 months and 6 months post operatively. Results: All the patients had severe hydronephrosis during diagnosis and 14 patients with unilateral UPJO were improved after PCN drainage and underwent pyeloplasty. The rest four patients that did not show improvement in the SRF and total volume of urine output underwent nephrectomy. In the patients with unilateral UPJO who improved after PCN drainage, the SRF was increased to 26.4% ±8.6% (mean± SD) after four weeks and pyeloplasty was performed. At three and six months follow-up, SRF value was 29.2% ±8.5% and 30.8.2% ±8.8% respectively. Conclusion: Before planning of nephrectomy in poorly functioning kidneys (SRF < 10%) due to congenital UPJO, PCN drainage should be done to asses improvement of renal function. Bangladesh Journal of Urology, Vol. 20, No. 2, July 2017 p.61-64

scholarly journals Surgical Repair of Posterior Urethral Distraction Defects and its Outcome : Initial Experience in a Tertiary Level Hospital

2020 ◽  
Vol 23 (2) ◽  
pp. 193-198
Author(s):  
Md Selim Morshed ◽  
Hafiz Al Asad ◽  
Md Fazal Naser ◽  
Uttam Karmaker ◽  
Md Towhid Belal ◽  
...  
Keyword(s):  
Surgical Procedure ◽  
Foley Catheter ◽  
Perineal Wound ◽  
Sexual Disorders ◽  
Urinary Flow ◽  
Tertiary Referral Hospital ◽  
College Hospital ◽  
Anastomotic Urethroplasty

Purpose: Management of posterior urethral distraction defects are challenging for urologists and need very careful and meticulous dissection for getting a good outcome. Dhaka medical college hospital is a tertiary referral hospital where we receive a lot of cases from different districts. The study was done to observe the outcome of anastomotic urethroplasty for posterior urethral distraction defects. Methods : This was a prospective experimental study. This study was done in a single unit of DMCH urology department by a single surgeon . Those who were suffering from posterior urethral distraction defects with suprapubic catheter in situ were included and underwent anastomotic urethroplasty from the period of January, 2018 to october, 2019. After proper evaluation and counseling all patients underwent perineal anastomotic urethroplasty under spinal anesthesia with 6-8 interrupted suture, using 4/0 vicryl. A 14 Fr Foley catheter was placed in urethral lumen and 16 Fr catheter in SPC site. A latex strip drain was placed for perineal wound. Drain was removed after 48 hours of operation . Patients were usually discharged in between 5th to 7th POD with definite follow up protocol and medications with supra pubic catheters (SPC) and per urethral catheters in situ. On 21 POD urethral catheter was removed. SPC was removed after 7 days if patient can void normally. 1st and 2nd follow up were done at the completion of 3rd and 6th month respectively. The prevalence of post-operative sexual disorders was investigated using the International Index of Erectile Function-5 (IIEF-5) questionnaire during follow-up. If the patient can able to void per urethra in a well manner and Qmax>15 mL/s then repair was defined successful. Result : Success rate of perineal anastomotic urethroplasty for posterior urethral distraction defect was 83.33.%. 18 patients were included in the study. The mean age was 28.27 years. 17 patients were able to void successfully after surgical procedure but among those 2 patients had urinary flow rate < 15 ml/sec and one patient didn’t able to void. 3 patients had developed wound infection, 3 patients developed erectile dysfunction. Conclusion : Perineal anastomotic urethroplasty is gold standard for treatment of posterior urethral distraction defects. Long term follow up is needed to give a opinion regarding the ultimate outcome of the surgical procedure and that have give a good idea for future management. Bangladesh Journal of Urology, Vol. 23, No. 2, July 2020 p.193-198

scholarly journals Genital Tuberculosis – An Uncommon Presentation

2012 ◽  
Vol 30 (2) ◽  
pp. 108-111
Author(s):  
N Akhter ◽  
A Khanam ◽  
F Begum
Keyword(s):  
Ulcer Patient ◽  
Rare Event ◽  
Married Women ◽  
College Hospital ◽  
Medical College ◽  
Uncommon Presentation ◽  
History Of ◽  
Papillary Growth ◽  
Tubercular Lesion

A married women of 30 years, mother of one child,  housewife was referred to out patient department of Khulna  Medical College Hospital with history of blood stained  vaginal discharge, secondary amenorrhoea for 3 years and  evening rise of temperature and anorexia for 3 months. On  speculum examination, cervix was oedematous, bright red  in colour with papillary growth which bleeds on touch. She  also had bilateral excavated lesion at the lowest part of the  vagina close to the introitus which was red in colour with  undermined edge. Visual inspection aided by acetic acid  (VIA) was positive. Colposcopy guided biopsy was taken  from unhealthy areas. There was extensive mottling on  chest X-ary. She had high ESR, AFB+ve on sputum culture.  The patient was diagnosed as a case of active pulmonary  TB. Histopathological report of cervical tissue showed  granulomatous lesion. Patient was given a regimen of  standard anti TB drugs. After 2 weeks, during her first  follow up, patient had few symptoms with regression of  cervical growth and disappearance of vaginal ulcer. Patient  herself stated about her wellbeing after the start of anti-  TB drugs.  Though cervical TB is not uncommon among genital TB  (5-24%), vaginal tubercular lesion is very uncommon and  concurrent pulmonary, endometrial, cervical and vaginal  tuberculosis is a rare event. Careful evaluation is needed to  diagnose tubercular infection in genital organs specially in  GOPDs and colposcopy clinics.   DOI: http://dx.doi.org/10.3329/jbcps.v30i2.11421   J Bangladesh Coll Phys Surg 2012; 30: 108-111  

scholarly journals Afferent loop syndrome: a case report

Mediscope ◽  
2016 ◽  
Vol 3 (2) ◽  
pp. 39-43
Author(s):  
Banga Kamal Basu
Keyword(s):  
Abdominal Discomfort ◽  
Mechanical Complication ◽  
College Hospital ◽  
Afferent Loop ◽  
X Ray ◽  
Afferent Loop Syndrome ◽  
Medical College ◽  
History Of ◽  
Endoscopic Investigation

Afferent loop syndrome (ALS) is a purely mechanical complication that infrequently occurs following construction of a gastrojejunostomy. A male patient aged 36 years who had undergone posterior gastro-jejunostomy 9 years back (in 2006) was admitted in the Department of Surgery of Gazi Medical College Hospital through OPD with abdominal pain, nausea, anorexia, abdominal discomfort after meal and sometime bilious vomiting. All the necessary investigations including endoscopy, colonoscopy, CT scan of the abdomen and Brain, Ba-meal X-ray were repeatedly done. There was suspicious distention of afferent loop during endoscopic investigation. The main diagnostic base was the history of the disease and clinically diagnosed ALS. It is a surgical urgency. During re-laparotomy, Roux-en-Y anastomosis with ‘Tanner’s 19’ modification was done. The patient did not have any complain during follow up after 10 days of the discharge from the hospital.Mediscope Vol. 3, No. 2: July 2016, Pages 39-43

scholarly journals EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY

2008 ◽  
Vol 15 (03) ◽  
pp. 367-370
Author(s):  
AMAN ULLAH ◽  
QURBAN ALI SHAIKH ◽  
ABDUL RASHEED SHAIKH ◽  
Malik Hussain Jalbani
Keyword(s):  
Shock Wave Lithotripsy ◽  
College Hospital ◽  
Ultrasound Localization ◽  
Medical College ◽  
Extracorporeal Shock Wave ◽  
Ureteric Calculi ◽  
Mean Size ◽  
Single Modality

Objective: To assess efficacy of ESWL as a single modality in upperand lower ureteric calculi. Setting: department of Nephro-Urology Chandka Medical College Hospital, Larkana.Period:January 2003 to April 2006. Methods and materials: 62 patients underwent ESWL. Upper and lower ureteral calculiwere treated by using Dornier MPL-9000 Lithotripter with ultrasound localization. Results: Among 62 cases 56(90.3%)patients had upper ureteric calculi, whereas 06(9.7%) patients had lower ureteric calculi. Size of stones ranged from0.5 mm to 18mm having mean size of 10mm. All patients were followed for period of 6 weeks. Of these 62 patients 58patients were stone free at the end of 2 weeks follow up. In 2 cases stones failed to fragment, where as 2 cases failedto attend out patient department for follow up. Conclusion: This study concluded that in situ echoguided ESWL waseffective modality of treatment for upper and lower ureteric stones. Localization of ureteric stones with ultrasound hasthe advantage of elimination of radiation exposure to the patient and lithotripsy team

scholarly journals Managment of Aplasia cutis congenita - early experience

1970 ◽  
Vol 1 (2) ◽  
pp. 20-22
Author(s):  
SI Hossain ◽  
FB Ibrahim ◽  
MMT Islam ◽  
MS Khondoker
Keyword(s):  
Maternal Smoking ◽  
Positive Family History ◽  
Early Experience ◽  
College Hospital ◽  
Aplasia Cutis Congenita ◽  
Medical College ◽  
Heterogenous Group ◽  
History Of ◽  
Aplasia Cutis

Background of the study: Aplasia cutis congenita refers to a heterogenous group of disorders in which  localized areas of skin are absent or scarred at birth. No definite etiology is available in literature. Strong genetic  predisposition is suspected.   Objectives: To overview observed cases and study the rare congenital anomaly.   Methods: Total 4 cases that reported in the department of plastic surgery, Dhaka Medical College Hospital included in the study. All the necessary data plotted and analyzed for purpose.   Results: None of the patients had positive family history. No parents had history of consanguinity of marriage. None of them had history teratogen exposure or taking drug during pregnancy. No positive history of maternal smoking or alcohol consumption noted. Both legs were most frequently involved 3 cases. Followed by scalp and hand. All the patients were advised for regular follow up. 1 patient died at the age of 30 days in home and lost follow up. Other patients improved after regular dressings DOI: http://dx.doi.org/10.3329/bdjps.v1i2.8801 BDJPS 2010; 1(2): 20-22

Outbreak Of Nipah Encephalitis In Greater Faridpur District

1970 ◽  
Vol 5 (2) ◽  
pp. 63-65
Author(s):  
MY Ali ◽  
SA Fattah ◽  
MM Islam ◽  
MA Hossain ◽  
SY Ali
Keyword(s):  
Health Personnel ◽  
Viral Encephalitis ◽  
Review Article ◽  
Personal Protection ◽  
Emerging Infections ◽  
College Hospital ◽  
Personal Protection Equipment ◽  
Medical College ◽  
History Of ◽  
Deadly Disease

Nipah viral encephalitis is one of the fatal re-emerging infections especially in southeast Asia. After its outbreak in Malaysia and Singapore; repeated outbreaks occurred at western part of Bangladesh especially in Faridpur region. Besides, sporadic attacks appear to occur in the country throughout the year. Here two Nipah outbreaks in greater Faridpur district in 2003 and 2004 are described along with brief review on transmission of the virus. Where the history of illness among patients are very much in favour of man to man transmission. Moreover the death of an intern doctor from Nipah encephalitis who was involved in managing such patients in Faridpur Medical College Hospital strongly suggests man to man transmission of this virus. So, aim of this review article to make the health personnel and general people be aware about man to man transmission of virus, so that they can adapt personal protection equipment (PPE) for their protection against this deadly disease. DOI: 10.3329/fmcj.v5i2.6825Faridpur Med. Coll. J. 2010;5(2):63-65

Lingual Dystonia Treated with Botulinum Toxin - A Case Report

1970 ◽  
Vol 24 (2) ◽  
pp. 75-78
Author(s):  
MA Hayee ◽  
QD Mohammad ◽  
H Rahman ◽  
M Hakim ◽  
SM Kibria
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
X Ray ◽  
Medical College ◽  
Lingual Dystonia ◽  
History Of ◽  
Chest X Ray

A 42-year-old female presented in Neurology Department of Sir Salimullah Medical College with gradually worsening difficulty in talking and eating for the last four months. Examination revealed dystonic tongue, macerated lips due to continuous drooling of saliva and aspirated lungs. She had no history of taking antiparkinsonian, neuroleptics or any other drugs causing dystonia. Chest X-ray revealed aspiration pneumonia corrected later by antibiotics. She was treated with botulinum toxin type-A. Twenty units of toxin was injected in six sites of the tongue. The dystonic tongue became normal by 24 hours. Subsequent 16 weeks follow up showed very good result and the patient now can talk and eat normally. (J Bangladesh Coll Phys Surg 2006; 24: 75-78)

Treatment of Pilonidal Sinus by Limberg Flap-Only Hope of Cure (Study of 50 Cases)

2020 ◽  
Vol 22 (2) ◽  
pp. 89-94
Author(s):  
Nasir Uddin Mahmud ◽  
ABM Khurshid Alam ◽  
Mohammad Altaf Hossain Chawdhury ◽  
Mohammad Abul Khair
Keyword(s):  
Pilonidal Sinus ◽  
Skin Barrier ◽  
Limberg Flap ◽  
College Hospital ◽  
Medical College ◽  
Flap Technique ◽  
Unpleasant Smell ◽  
Lower Morbidity ◽  
Computer Operator

Background : Pilonidal sinus was first described by Dr. A.W. Anderson in 1847 and is often seen in the intergluteal region. It is a disease of mainly younger male and rarely affects after 40. Main causes for the formation of this sinus are hirsutism, sweating in the area, repeated maceration due to trauma, leading to breakage of the skin barrier, attracting hair inside which initiates a foreign body reaction leading to infection with abscess or sinus formation. Most common embarrassing situation is discharging sinus. The diagnosis is mainly on clinical ground. Though there are a lot of modalities of treatment but recurrence is still a challenge. We have adopted Limberg flap technique since 2012 with a least recurrent chance. Objectives : To prove that this procedure will be end up with lower morbidity & least chance of recurrence Methods : This prospective study was done jointly by the Department of Surgery of Central Medical College and Comilla Medical College Hospital. In this series 50 patients were selected from July 2012 to June 2017. Results : Out of 50 patients operated by Limberg flap technique 42(84%) were males and 8(16%) were females. Mean age was 27.3 years (range 18–37years). Of them,12(24%) were driver, 6(12%) police, 6(12%) teacher, 6(12%) student, 5(10%) worker, 4(8%) millitary army, 4(8%) housewife, 4 (8%)service holder, 2(4%) computer operator, 1(2%) doctor and 1(2%) were barber. In our study most common mode of presentation were chronic discharging sinuses 15(30%), beside this 12(24%) had multiple sinuses, 10(20%) had multiple pits,7(14%) had acute abscess and 6(12%) had unpleasant smell. Associated hirsutism were present in 30(60%) and absent in 20(40%) patients. One (2%) male patient had wound gap & discharge and six(12%) patients had flap edema. We have found no recurrence in follow up period. Conclusion : Pilonidal sinus is a notoriously recurrent disease, so treatment by this flap technique is the only hope of cure with lower morbidity. Journal of Surgical Sciences (2018) Vol. 22 (2) : 89-94

Thirty Year Old Female Presented with Nipple Destruction: A Case Report

2019 ◽  
Vol 11 (1) ◽  
pp. 81-83
Author(s):  
Md Mustafizur Rahman ◽  
Nadim Ahmed ◽  
Sami Ahmad ◽  
Shoaeb Imtiaz Alam ◽  
Mohammad Rashedul Hassan ◽  
...  
Keyword(s):  
Invasive Carcinoma ◽  
Paget’S Disease ◽  
Radical Mastectomy ◽  
Paget's Disease ◽  
College Hospital ◽  
Rare Type ◽  
Medical College ◽  
Ductal Cell ◽  
Areola Complex

Paget’s disease of the breast is a rare type of cancer of the nipple–areola complex and that is often associated with an underlying in situ or invasive carcinoma. It is often misdiagnosed as eczema of breast and treatment is delayed. Here we present a case where a 30 year old female presented with itching ulceration and destruction of her left nipple. She was treated initially by local physicians by applying local ointments but as her condition did not improve she was admitted to department of surgery Shaheed Suhrawardy Medical College hospital where she was diagnosed as Paget’s disease with infiltrating ductal cell carcinoma. She underwent modified radical mastectomy with axillary clearance and referred to oncology department for further management. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 81-83

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