Gastrointestinal polyps are described as abnormal lesions that originate in the gastric epithelium or sub mucosa and protrude into the stomach lumen. It may present as an isolated lesion, or could be multiple as part of juvenile polyposis. It could be hereditary or acquired; hamartomatous or hyperplastic in structure; sessile or pedunculated in shape and of benign or malignant origin. Rectal lesions are the commonest in children but gastric polyps are rarely described in this age group, especially in those less than five years old [1]. Clinical presentation of gastric polyps in children varies widely, from incidental endoscopic finding to massive gastrointestinal bleeding [1]. We report a case of unusual upper gastrointestinal bleeding causing severe anaemia requiring blood transfusion secondary to gastric polyp in a young child. A 5-year old otherwise healthy girl presented to the local hospital with a short history of lethargy and pallor. There was no history of vomiting or diarrhoea initially but after 2 days she developed melaena. Clinically she was found to be pale and tachycardic initially with a systolic heart murmur, which resolved after transfusion. There was no evidence of hepato-splenomegaly, lymphadenopathy or jaundice. She was born at full term and had no history of hospital admission. Her initial investigations showed a slightly raised CRP of 38 mg/l and low Haemoglobin of 4.6 grams/dl; which warranted an urgent blood transfusion. Otherwise her renal function, coagulation screen and liver functions were all within normal limits. Abdominal ultrasound scan findings were normal. A meckle's radioisotope scans showed no evidence of Meckle's diverticulitis. After stabilization she was referred for an urgent gastroscopy, which revealed an intragastric mass extending across the pylorus (Figure 1). MRI abdomen showed a large sessile gastric mass in the pyloric lesser curvature extending to the first part of the duodenum (Figure 2). Surgical excision was decided after multidisciplinary meeting and a written consent was obtained. She underwent laparotomy via upper transverse abdominal incision. A well-circumscribed lesion originating from gastric wall with intact serosa was completely excised. She had full recovery without any complications. Repeated haemoglobin prior to discharge rose to 9.8 gm/dl and no further episode of melaena was reported. Histopathology confirmed non-neoplastic non-hamartomatous gastric polyp measured 6.5 × 2.5 × 2 cm.
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 patients satisfaction as well as surgeons professional gratification.Key words: Microtia; Two stage auricular reconstruction; Autologous costochondral cartilageBDJPS 2010; 1(2): 14-19
CorrigendumThere is correction in the Journal of Dhaka Medical College, April 2009 issue (Vol. 18, No. 1). In the original article titled "Treatment of vitiligo with autologous epidermal transplantation using the roof of suction blisters, first in Bangladesh", the name of the first author will have to be read Khondoker MS instead of Khundkar SH, and in address of correspondence Dr. Md. Sajjad Khondoker instead of Prof. Shafquat Hussain Khundkar at page no. 58.On 15/02/2011, the first author's name was changed from SH Khundkar to MS Khondoker on the online edition of the journal on BanglaJOL.We report our experience of autologous epidermal transplantation for 30 (Thirty) patients with vitiligo. The vitiligo in 25 (Twenty five) patients was stable whereas in the rest (5) it was active. Autologous epidermal transplantation was performed using suction blister roofs from normal pigmented skin to vitiligo skin that was failed to repigment using topical steroid and/or psoralenultraviolet- A treatment. Grafts were well taken in all the patients. Only three of them are presented as case report in this article. There were no complications except mild hyper pigmentation at the donor areas. For the patient who had active vitiligo, depigmentation of the graft and concomitant Koebner‘s phenomenon at the donor site were observed 3 weeks after the procedure. We conclude that autologous epidermal transplantation using the roof of suction blisters is an excellent and safe regimenting procedure for stable, localized vitiligo and the active disease precludes transplantation. Key words: Epidermis surgery; vitiligo therapy; transplantation alutologous. DOI: 10.3329/jdmc.v18i1.6308 J Dhaka Med Coll. 2009; 18(1) : 58-63
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.
Background: Hair transplantation is one of the most evolving procedures in aesthetic surgery accompanied by regular improvement in technique. The recent advancement in technology and the concept of using follicular unit grafts have made this procedure reach a new height. A precise appreciation of anatomy has allowed the use of follicular unit graft. With better methods of harvesting and implantation, hair transplantation results represent a blend of art and science. Materials & method: 60 patients underwent hair transplant surgery from July/2008 to June/2009. Age limit was 18-58 years. Patients were evaluated and prepared in standard way. Operations were done by Robotic follicular unit graft by a specially designed machine. Procedures were performed under nerve block and local infiltration .Grafting sessions lasted for 5-6 hours, during which 1500-2000 FUGs were transplanted. Patients were discharged on the same day. Results: Minimum complications were observed. Most of the patients were satisfied except a few. Some patients needed second sitting surgery. Conclusion: With better methods of harvesting and implantation, Hair transplantation, if done judiciously, is a very rewarding procedure, both for the surgeon and the patient.DOI: http://dx.doi.org/10.3329/bdjps.v1i1.6488Bangladesh Journal of Plastic Surgery (2010) Vol. 1 (1) pp.19-23
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