Journal of Shaheed Suhrawardy Medical College, 2021
Pilonidal sinus in the sacrococcygeal region is an acquired condition and usually seen in young m... more Pilonidal sinus in the sacrococcygeal region is an acquired condition and usually seen in young male adults. Diagnosis is indicated by to see the site and appearance of chronic discharging opening, and identification of midline pit in the natal cleft. The management of the sacrococcygeal pilonidal sinus varies from clipping of hairs with good hygiene of the area, wide excision of the area with primary or secondary closure and newer flap procedures, but none is widely accepted. The main concern for the treatment to the patient is the recurrence. This prospective study has been performed to determine the effectiveness and safety of the Limberg flap procedure for sacrococcygeal pilonidal sinus for new and recurrent cases. Primary end point was rate of recurrence and secondary end points were its complianceand complications such as wound infection, postoperative pain and return to work. A total of 17 patients were operated from March 2012 to June 2016.Both primary and recurrent diseases...
Background: Gall stones are the most common biliary pathology. Subclinical hypothyroidism is not ... more Background: Gall stones are the most common biliary pathology. Subclinical hypothyroidism is not an uncommon problem in the population with thyroid disease, several explanations for a possible relation between hypothyroidism and lipid metabolism with gall stone formation proved that prevalence of gall stones is increased in patients with hypothyroidism. Objective: To find the prevalence and correlation between the subclinical hypothyroidism and gall stone disease. Methods: This is a cross-sectional study was done in the Unit-II of department of Surgery of Shaheed Suhrawardy Medical Hospital between July 2018 to June 2019, where 80 patients presented with gall stones. All the patients were assessed and prepared for cholecystectomy by detailed history, clinical examination, thyroid function test, abdominal ultrasound and others investigation needed for general anaesthesia. Results: Among 80 patients, 78.57% were in 40–59 year age group, 56 (70%) of them were female and 24 (30%) were m...
Journal of Shaheed Suhrawardy Medical College, Sep 17, 2019
Chronic pancreatitis is a fairly common condition with pain being the major symptom and longitudi... more Chronic pancreatitis is a fairly common condition with pain being the major symptom and longitudinal pancreaticojejunostomy (LPJ) is performed for symptomatic relief. The aim of the study is to assess the outcome of LPJ for chronic calcific pancreatitis and to evaluate the factors influencing relief of symptoms. A prospective observational study enrolling 28 patients was conducted in the department of surgery of Shaheed Suhrawardy Medical College Hospital from January 2018 to December 2018. This study involved identification of various risk factors related to chronic pancreatitis, pancreaticojejunostomy, early post-operative outcome and postoperative assessment of pain relief at 1 and 6 months from surgery. Pain was assessed using Visual analogue scale (VAS). In chronic pancreatitis, there is a significant relief of pain in post-LPJ; the degree of relief was less in the alcoholics than non-alcoholics (p=0.09) and in smokers. There was also reduction in analgesic requirement and frequency of acute attacks of pain. In chronic pancreatitis, there is a significant relief of pain in post-LPJ, although the degree of relief is less in the alcoholics and smokers.
Paget's disease of the breast is a rare type of cancer of the nipple-areola complex and that is o... more 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.
Background: Ulcers and surgical wounds not healing well and expectedly are common problems among ... more Background: Ulcers and surgical wounds not healing well and expectedly are common problems among patients in countries like us. Ulcers may develop spontaneously or following a penetrating injury. wounds not healing well are common among poor, lower middle class and middle class people. Postsurgical non-healing wound or chronic discharging sinuses at the scar site are also common in that class of people. Suspecting malignancy or tuberculosis in these types of wounds we have sent wedge or excision biopsy for these ulcers in about 500 cases and found tuberculosis in 65 cases. In rest of the cases histopathology reports found as non- specific ulcers, Malignant melanoma, squamous or basal cell carcinoma, Verruca vulgaris. Objectives: To find out the relationship of tuberculosis with chronic or nonhealing ulcers. Methods: This is a prospective observational study conducted for patients coming to our chambers, OPD of a district general hospital and Shaheed Suhrawardy Medical College Hospit...
Intussusception is a relatively common etiology of abdominal pain in pediatric population. In adu... more Intussusception is a relatively common etiology of abdominal pain in pediatric population. In adults, on the other hand, this entity is seen infrequently and a lead point can be recognized in a vast majority of cases. A 27 year old woman who was admitted in the Surgery Department of Shaheed Sohrawardy Medical College Hospital after experiencing severe upper abdominal pain associated with nausea, vomiting and fever. Later on the patient developed features of intestinal obstruction. Ultrasonography demonstrated small bowel intussusception. A jejunal intussusception 50 cm distal to the dudeno-jejunal junction was found during laparotomy. Resection and anasto mosis was performed as gut was not viable. A diagnosis of jejunal inflammatory fibroid polyp was made based on the histological findings which act as a lead point for jejunal intussusception. J Shaheed Suhrawardy Med Coll, December 2018, Vol.10(2); 111-114
Haemophilia A is an X linked disorder characterized by bleeding manifestations due to deficiency ... more Haemophilia A is an X linked disorder characterized by bleeding manifestations due to deficiency of factor VIII. Administration of factor VIII is the mainstay of treatment in case of bleeding which is very costly. That’s why fresh frozen plasma is a very good alternative in the management of mild to moderate bleeding. Here we present a case of 50 years old male presented to us with traumatic scrotal haematoma who was newly diagnosed with Haemophilia A. As the patient was unable to bear the cost of factor VIII, we managed the patient by transfusing fresh frozen plasma. After raising his activity of factor VIII up to 30% which was adequate for soft tissue trauma, surgical exploration of scrotum was done. Both the testes were found viable. Evacuation of clot was done followed by secondary closure of the wound J Shaheed Suhrawardy Med Coll, December 2018, Vol.10(2); 118-121
The value of thrombolysis by Streptokinase administration in the treatment of acute myocardial in... more The value of thrombolysis by Streptokinase administration in the treatment of acute myocardial infarction is well established. Haemorrhage is a common complication of fibrinolytic therapy. Here, we report an unusual case of spontaneous lingual and sublingual haematoma following streptokinase therapy after acute myocardial infarction. A 57-year-old man with a diagnosis of acute ST elevated myocardial infarction treated with streptokinase developed a large lingual and sublingual haematoma. Though his airway was not compromised, he had difficulty in swallowing. A conservative approach was made by starting parenteral nutrition, preventing rethrombosis by not reversing the action of streptokinase as his coagulation profile was within normal limits and maintaining optimum blood pressure, blood glucose level and urine output. His tongue swelling subsided after four days and oral medication and feeding was started. No complication occurred during this period. Though there is no adequate inf...
Journal of Shaheed Suhrawardy Medical College, 2021
Pilonidal sinus in the sacrococcygeal region is an acquired condition and usually seen in young m... more Pilonidal sinus in the sacrococcygeal region is an acquired condition and usually seen in young male adults. Diagnosis is indicated by to see the site and appearance of chronic discharging opening, and identification of midline pit in the natal cleft. The management of the sacrococcygeal pilonidal sinus varies from clipping of hairs with good hygiene of the area, wide excision of the area with primary or secondary closure and newer flap procedures, but none is widely accepted. The main concern for the treatment to the patient is the recurrence. This prospective study has been performed to determine the effectiveness and safety of the Limberg flap procedure for sacrococcygeal pilonidal sinus for new and recurrent cases. Primary end point was rate of recurrence and secondary end points were its complianceand complications such as wound infection, postoperative pain and return to work. A total of 17 patients were operated from March 2012 to June 2016.Both primary and recurrent diseases...
Background: Gall stones are the most common biliary pathology. Subclinical hypothyroidism is not ... more Background: Gall stones are the most common biliary pathology. Subclinical hypothyroidism is not an uncommon problem in the population with thyroid disease, several explanations for a possible relation between hypothyroidism and lipid metabolism with gall stone formation proved that prevalence of gall stones is increased in patients with hypothyroidism. Objective: To find the prevalence and correlation between the subclinical hypothyroidism and gall stone disease. Methods: This is a cross-sectional study was done in the Unit-II of department of Surgery of Shaheed Suhrawardy Medical Hospital between July 2018 to June 2019, where 80 patients presented with gall stones. All the patients were assessed and prepared for cholecystectomy by detailed history, clinical examination, thyroid function test, abdominal ultrasound and others investigation needed for general anaesthesia. Results: Among 80 patients, 78.57% were in 40–59 year age group, 56 (70%) of them were female and 24 (30%) were m...
Journal of Shaheed Suhrawardy Medical College, Sep 17, 2019
Chronic pancreatitis is a fairly common condition with pain being the major symptom and longitudi... more Chronic pancreatitis is a fairly common condition with pain being the major symptom and longitudinal pancreaticojejunostomy (LPJ) is performed for symptomatic relief. The aim of the study is to assess the outcome of LPJ for chronic calcific pancreatitis and to evaluate the factors influencing relief of symptoms. A prospective observational study enrolling 28 patients was conducted in the department of surgery of Shaheed Suhrawardy Medical College Hospital from January 2018 to December 2018. This study involved identification of various risk factors related to chronic pancreatitis, pancreaticojejunostomy, early post-operative outcome and postoperative assessment of pain relief at 1 and 6 months from surgery. Pain was assessed using Visual analogue scale (VAS). In chronic pancreatitis, there is a significant relief of pain in post-LPJ; the degree of relief was less in the alcoholics than non-alcoholics (p=0.09) and in smokers. There was also reduction in analgesic requirement and frequency of acute attacks of pain. In chronic pancreatitis, there is a significant relief of pain in post-LPJ, although the degree of relief is less in the alcoholics and smokers.
Paget's disease of the breast is a rare type of cancer of the nipple-areola complex and that is o... more 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.
Background: Ulcers and surgical wounds not healing well and expectedly are common problems among ... more Background: Ulcers and surgical wounds not healing well and expectedly are common problems among patients in countries like us. Ulcers may develop spontaneously or following a penetrating injury. wounds not healing well are common among poor, lower middle class and middle class people. Postsurgical non-healing wound or chronic discharging sinuses at the scar site are also common in that class of people. Suspecting malignancy or tuberculosis in these types of wounds we have sent wedge or excision biopsy for these ulcers in about 500 cases and found tuberculosis in 65 cases. In rest of the cases histopathology reports found as non- specific ulcers, Malignant melanoma, squamous or basal cell carcinoma, Verruca vulgaris. Objectives: To find out the relationship of tuberculosis with chronic or nonhealing ulcers. Methods: This is a prospective observational study conducted for patients coming to our chambers, OPD of a district general hospital and Shaheed Suhrawardy Medical College Hospit...
Intussusception is a relatively common etiology of abdominal pain in pediatric population. In adu... more Intussusception is a relatively common etiology of abdominal pain in pediatric population. In adults, on the other hand, this entity is seen infrequently and a lead point can be recognized in a vast majority of cases. A 27 year old woman who was admitted in the Surgery Department of Shaheed Sohrawardy Medical College Hospital after experiencing severe upper abdominal pain associated with nausea, vomiting and fever. Later on the patient developed features of intestinal obstruction. Ultrasonography demonstrated small bowel intussusception. A jejunal intussusception 50 cm distal to the dudeno-jejunal junction was found during laparotomy. Resection and anasto mosis was performed as gut was not viable. A diagnosis of jejunal inflammatory fibroid polyp was made based on the histological findings which act as a lead point for jejunal intussusception. J Shaheed Suhrawardy Med Coll, December 2018, Vol.10(2); 111-114
Haemophilia A is an X linked disorder characterized by bleeding manifestations due to deficiency ... more Haemophilia A is an X linked disorder characterized by bleeding manifestations due to deficiency of factor VIII. Administration of factor VIII is the mainstay of treatment in case of bleeding which is very costly. That’s why fresh frozen plasma is a very good alternative in the management of mild to moderate bleeding. Here we present a case of 50 years old male presented to us with traumatic scrotal haematoma who was newly diagnosed with Haemophilia A. As the patient was unable to bear the cost of factor VIII, we managed the patient by transfusing fresh frozen plasma. After raising his activity of factor VIII up to 30% which was adequate for soft tissue trauma, surgical exploration of scrotum was done. Both the testes were found viable. Evacuation of clot was done followed by secondary closure of the wound J Shaheed Suhrawardy Med Coll, December 2018, Vol.10(2); 118-121
The value of thrombolysis by Streptokinase administration in the treatment of acute myocardial in... more The value of thrombolysis by Streptokinase administration in the treatment of acute myocardial infarction is well established. Haemorrhage is a common complication of fibrinolytic therapy. Here, we report an unusual case of spontaneous lingual and sublingual haematoma following streptokinase therapy after acute myocardial infarction. A 57-year-old man with a diagnosis of acute ST elevated myocardial infarction treated with streptokinase developed a large lingual and sublingual haematoma. Though his airway was not compromised, he had difficulty in swallowing. A conservative approach was made by starting parenteral nutrition, preventing rethrombosis by not reversing the action of streptokinase as his coagulation profile was within normal limits and maintaining optimum blood pressure, blood glucose level and urine output. His tongue swelling subsided after four days and oral medication and feeding was started. No complication occurred during this period. Though there is no adequate inf...
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