There is unequal access to surgical health care in underdeveloped countries such as Bangladesh. Bangladesh has a large young population, with 70 % of the population living in rural areas. All of the pediatric surgical services of the country are situated in major cities. We therefore organized an outreach service with the aim of providing surgical services to these rural children by utilizing the existing facilities of primary and secondary care centers. The program originated at the Department of Pediatric Surgery, Chittagong Medical College and Hospital in Sept 2008. The data presented here are from its 2008 beginning to Nov 2011. A yearly plan is sent to the Divisional Director of Health Services for Chittagong Division, who notifies all of the concerned district hospitals (DHs) and Upazila Health Complexes (UHCs). A member of the outreach team contacts each center via telephone 1 month prior to the visit to help organize it. Doctors at each participating hospital in which day surgery is possible are informed as to which commonly performed day surgeries are available, and they then select the appropriate patients to be examined at that visit. The local doctors are also advised to choose other pediatric surgical patients as outpatients. The local doctors perform the follow-up. If necessary, patients are referred to our department for further management. During the study period, we made 32 visits to 5 DHs and 10 UHCs. In all, 674 children were seen as outpatients, and 407 underwent surgery, of which inguinal hernia repair was the most common. There were no deaths. Outreach service is a good way to extend curative care to the grass-roots population.
Local anesthesia is an established option for the most fragile neonates with major surgical disease. Safe anesthesia ought to be accessible to all children of the world. The global pandemic of perioperative mortality needs to be addressed.
This study was conducted to assess the antioxidant potential and thrombolytic activity of the methanolic extract of the Delonix regia leaves and its partitionates. The methanolic extract was partitioned into four fractions (pet ether, dichloromethane, ethyl acetate, and aqueous) according to polarity. These fractions were subjected to further investigation. The antioxidant potential was assessed by two methods one was by using the Folin-Ciocalteu reagent as oxidant and gallic acid as a standard; and another method was the DPPH assay. In Folin-Ciocalteu reagent using method, all fractions showed significant antioxidant potential and the ethyl acetate partitionate showed the highest antioxidant activity at 142.28 mg of GAE/gm of extractives among all. In the DPPH assay, the antioxidant potential was measured compared against BHT, all fractions showed better activity than the BHT and the highest IC50 value was 51.06 μg/mL of dichloromethane partitionate. In thrombolytic activity, streptokinase was the positive control, and water was the negative control. The highest thrombolytic activity was found in petroleum ether partition and methanolic extract and the IC50 value were 47% and 30.65%, respectively. Whereas the IC50 value of streptokinase and water was 64.22% and 15.48% respectively.
Bangladesh Pharmaceutical Journal 26(1): 73-78, 2023 (January)
:For decades, vesical stone has been removed by traditional cystolithotomy. It gives a big scar and adds considerable morbidity to the patient. Here we tried a new indigenous technique to remove the bladder stone with a laparoscopic grasper . The aim was to minimize the morbidity and an almost invisible scar to the patient.
Rectal stenosis is a rare variety of rectal atresia. A membrane separates the rectum from the anal canal in the presence of a normal anus. We report a case of rectal stenosis associated with Down's syndrome and hypothyroidism in whom rectal stenosis was diagnosed at the age of 17 years.
Adrenal cysts are rare clinical condition that can present as abdominal swelling and chronic abdominal pain with weight loss. A 26 year old girl presented to our hospital with a 3 years history of right sided abdominal swelling and cachexia. Ultrasound of the abdomen reaveled a cystic area measuring 20x18 cm below the liver. Computed tomography scan showed a large cystic homogenous mass measuring 20x18x18.5cm in the right hypochondrium with most likely origin from the right adrenal gland. IVU showed left sided kidney was absent and left sided crossed ectopia was present. Both kidney on right side was pushed downwards. limited work up for hormone done. Hypersecretion was negative.A laparotomy with right adrenalectomy was performed. Final pathology showed a benign adrenal endothelial cyst.post operative period was unevenful. Surgical resection appears a safe and reasonable management strategy in a patient with adrenal cyst.
Bangladesh Journal of Urology, Vol. 18, No. 1, Jan 2015 p.43-46
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