No abstract

Study objective-The aim ofthe study was to investigate the influence of consanguinity on children's health.Design-The study is a prospective survey from birth to five years ofa cohort ofbabies born in a multiracial community. This report details the initial findings on consanguinity.Setting-Participating families live predominantly in three health districts of Birmingham, and were recruited in three local maternity hospitals.

No abstract

A prospective study of 4934 babies of different ethnic groups has confirmed the high perinatal mortality rate for Pakistanis and has shown that this was not due to a reluctance to terminate a fetus who is known to be seriously malformed. The major cause of early mortality was a high rate of lethal malformations, which occurred in about 1 in 100 Pakistani babies and which accounted for about half of their perinatal mortality. Many of these were autosomal recessive and occurred only in the offspring of consanguineous parents. However, there was also an excess of lethal cardiac malformations which were not associated with parental consanguinity. The remainder of the excess perinatal mortality was probably due to socio-economic factors. These causes are partly amenable to preventive measures, such as the referral of Pakistani women for expert ultrasonography at 18 to 20 weeks of pregnancy.

Background: Gall bladder cancer (GBC) is a burning topic of discussion in the recent era of laparoscopic cholecystectomy. In 1% of patients undergoing cholecystectomy for cholelithiasis, an incidental gallbladder carcinoma is discovered. Reports of laparoscopic cholecystectomies for cholelithiasis have resulted in earlier discovery of gallbladder cancer. So an increasing number of gall bladder cancer patients in earlier stage are now attending physicians and surgeons. These patients have an excellent chance of survival if aggressively and appropriately managed. Radical cholecystectomy is the only potentially curative therapy for this group of patients. It is crucial to make proper treatment decisions early, rather than after a cholecystectomy - an operation that is incomplete except for the earliest stage of the disease.Present study is a small document about the various presentations and management of gall bladder cancer. It will highlight the options available to patients in Bangladesh which is certainly in line with the internationally accepted standard treatment. Methods: This observational study included patients with confirmed gall bladder malignancy (pre-operative, intra- operative or post- operative) presenting in Hepato-Bialiary-Pancreatic Surgery unit (HBPS), of Bangladesh institute of Diabetes, Endocrine and Metabolic Disorders (BIRDEM) Hospital, in 2004-2005. The patients were diagnosed with detail history, proper clinical examinations and appropriate investigations. The disease status was staged and the patients were appropriately counselled. Patients presenting in stage Ib, II and a few stage III patients underwent loco-regional enblock resection of malignant gall bladder with regional hepatic segments (IVB & V), without violating the cystic plate, skeletonization of hepatoduodenal ligament, clearance of fascia, fat of hepatic hilum with/without excision of bile duct followed by Roux-en-Y hepatico/ cholangio- jejunostomy, where necessary. Patients in advanced stages underwent some form of palliative procedure. All were regularly followed by a standard protocol. Results: This study comprise of 20 consecutive cases of GBC. Three (15%) patients presented with histopathological report of gall bladder malignancy after cholecystectomy. Seven (35%) patients underwent curative enmass resection. Thirteen patients (65%) were offered, appropriate palliative procedure. In this study, 35% cases had a disease free survival of five years. These were the cases in stage Ib & II who underwent a curative radical resection (enmass resection or bisegmentectomy after cholecystectomy). The rest of the patients (65%) had very poor survival. They were the patients in Stage III & IV disease who underwent some sort of palliative procedure with or without chemotherapy. The mean survival in these patients was 7.2 months. Conclusion: With improvements in imaging, staging and hepatic and biliary resection, there is now hope for patients with non-metastatic gallbladder cancer. Radical surgery has been shown to be effective in properly selected patients. It is very important to carry out a proper broad scale study of these cancers in our country. A detailed study will invariably strengthen our efforts to combat this killer disease. More studies need to be done in this context to draw any inference regarding the best way of handling this gloomy condition. Birdem Med J 2019; 9(1): 23-29

No abstract

No abstract

Aims: The aims of the study were to compare the safety and benefits of laparoscopic versus open appendicectomy.Methods: This cross-sectional study was done in BIRDEM General Hospital from June 2005 to December 2006.Seventy patients with acute appendicitis were included in this study, half underwent laparoscopic procedure and half open conventional procedure.We evaluated the length of hospitalization, postoperative morbidity (pain, wound infection, chest complication, paralytic ileus),cosmesis and return to normal activity among two methods of operations.Results: The duration of surgery in open group was 30 to 70 minutes with a mean duration of 47.57 minutes. In case of laparoscopic group the mean duration was 38.71 minutes with a range from 30 to 60 minutes. In open group 28 cases (80.0%) required opioid for satisfactory pain relief whereas in laparoscopic group only 9 (25.71%) cases required opioid. Gross infection with pus collection occurred in 2 (5.7%) cases in open appendicectomy (OA) group and none inlaparoscopic appendicectomy (LA) group. Post-operative hospital stay in open group ranged from 2 to 18 days with a mean of 6.74 days. For laparoscopic group the duration was 1 to 5 days with a mean of 2.31 days. Patients in open procedure returned to normal activity within 11-23 days with a mean of 15 days and in lap group the figures were 2-15 days and 6 days respectively. In open group 65.71% (n=23) were satisfied with the scar they had whereas 91.4% (n=32) were satisfied with their scar in lap group.Conclusion: The study indicates that the laparoscopic appendicectomy is feasible and safe for majority of patients with acute appendicitis.Birdem Med J 2015; 5(1) Supplement: 13-17