Splenic cysts are rarely detected, and clinically diagnosed commonly as spleenomegaly . Thenature of the cyst could not be diagnosed pre-operatively because of its’ anatomical location andonly be confirmed by the histopathological assessments. These cysts are found as a sequel ofsplenic infarct followed by the abscess formation. This is a very rare condition of a minor boy ofonly 10 years’ old who presented with a hugely enlarged spleen. The common investigation(s)did not prove that it was in the haematological conditions. Ultrasonogram (USG) investigationshows spleenomegaly due to the cystic lesion. CT scan of the abdomen showed large andwell defined cystic mass which was 13.4cmX7.9cmX15.3cm in size, multi-loculated, septated,sharply demarcated as such well delineated cyst. After necessary preparation like vaccination,blood grouping, cross matching and other fitness, laparotomy and total spleenectomy was doneas the cyst occupied most of the Splenic tissue. The post operative recovery was uneventful andthe final diagnosis was confirmed by histopatholgical examinations as epidermoid cyst of thespleen. The patient was followed up for two consecutive months and not a single complicationwas noticed. Bangladesh Journal of Medical Science Vol.20(1) 2021 p.177-180
Original Research ArticleIntroduction: Femoral shaft fractures are most common fractures in paediatric age group having different options to treat them. Elastic stable intramedullary nailing is one for treating these fractures and has a reliable methodology. Objective: The aim of this study is to evaluate the short term clinical, functional and radiological outcome of intramedullary fixation of displaced femoral shaft fractures in skeletally immature children using titanium elastic nails. Material and Methods: 36 femoral shaft fractures in 36 children aged 6-14 years were fixed with titanium intramedullary elastic nail between July 2017 and December 2018 in the department of Orthopaedics, Shaheed Ziaur Rahman Medical College Hospital, Bogura, and in some private hospitals in Bogura, Bangladesh. Two nails of proper and equal diameter were used for fracture fixation. No external splint was used after surgery. Outcomes assessed on the basis of Flynn et al. scoring criterion. Results: All patients achieved complete healing at a mean of 9.1 (Range 8-10) weeks. 31 fractures were reduced by closed means but 5 needed open reduction. No major complication was recorded. Most common minor complication was entry site skin irritation recorded in 4 patients. 86% had excellent result and 14% had satisfactory. Conclusion: Elastic stable intramedullary nailing is the method of choice for the femoral shaft fractures in paediatric patients, because it is minimally invasive and shows very good functional and cosmetic result. It allows early ambulation and shorter hospital stay and higher parent satisfaction. It also provides flexural, translational and rotational stability as well.
Background: Despite improvements in burn management, infection is still the biggest challenge in major burn cases globally. Burn causes extensive tissue destruction, immune dysfunction, increases the risk of infection and septicemia with high morbidity and mortality. The aim of this study was to observe the levels of serum fibrin degradation product (FDP), D-dimer and procalcitonin in patients with burn sepsis treated in intensive care unit (ICU). Materials & Methods: This observational study was carried out in Department of Burn and Plastic Surgery, Dhaka Medical College Hospital, Dhaka from February 2018 to January 2019. Forty (40) patients with major burns, from (15% to 50% total body surface area burn) with burn sepsis, were recruited for the study. In all cases, plasma level of fibrin degradation product (FDP), D-dimer and procalcitonin were measured and recorded. Result: Male predominance (57.5%) was observed in our study. Eighty five percent (85%) patients had total body surface area burn (TBSA) 20% to 50%. Sixteen patients (40%) suffered from flame burn, 13 (32.5%) patients from scalds and 11 (27.5%) patients had high voltage electric burn. The value of FDP was raised in 62.5% patients, D- dimer in 67.5% patients. Serum procalcitonin level was high (> 2ng/ml), indicating burn sepsis in 47.5% cases but it was not significant (2 sample t – test reveals no significant relationship between rise of serum level of procalcitonin and presence of burn sepsis) Conclusion: Fibrin degradation product (FDP) and D- dimer were raised in two-thirds of burn cases while procalcitonin in two-fifths cases. Measurement of serum level of FDP, Ddimer and procalcitonin may give an idea regarding early onset of bacterial infection and burn sepsis and can serve as an indicator for burn sepsis. J Bangladesh Coll Phys Surg 2023; 41: 193-197
Choledochal Cyst is a relatively rare condition. Even rarer is a choledochal cyst in association with a gallbladder carcinoma. This study reports a rare case of choledochal cyst coexisting with gallbladder carcinoma in a Bangladeshi patient. A 35 year old lady presented at IBN Sina Medical College Hospital, Kallyanpur, Dhaka with the history of recurrent right upper quadrant abdominal pain from childhood, which became severe for last 4 days before admission. The pain was colicky in nature and radiated to the back. Episodes were associated with low-grade fever, anorexia as well as vomiting. The preoperative diagnosis was made by abdominal ultrasound and MRCP. Exploratory laparotomy, enbloc cholecystectomy with excision of the choledochal cyst and roux-en-Y hepaticojejunostomy was also done. Post operative recovery was uneventful. Patient was followed up for six months and no obvious complication was noticed. Early suspicion of this rare pancreato-billiary disease is important because surgical treatment is the only way to avoid the complications of the disease.Bangladesh Journal of Medical Science Vol.16(4) 2017 p.602-605
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