Factors responsible for major complications following thyroid surgery in 598 patients were studied. Patients with non toxic multinodular goiter involving both lobes of thyroid constituted the maximum bulk subjected to thyroidectomy. The most frequent procedure was bilateral subtotal thyroidectomy. Reactionary hemorrhage occurred in 6 patients, all following bilateral procedures and among them 5 patients developed tension hematoma with respiratory obstruction despite the presence of a drain. Temporary vocal cord palsy was observed in 7 patients whereas one patient subjected to total thyroidectomy with neck dissection for papillary carcinoma of thyroid developed permanent right vocal cord palsy. Temporary parathyroid insufficiency was seen in 51 patients and one patient developed permanent hypoparathyroidism. Incidence of parathyroid insufficiency was higher in bilateral procedures as compared to unilateral ones. There was no operation related death in this series, but complications like hemorrhage, vocal cord palsy and parathyroid insufficiency following thyroid surgery are still a deep concern.

The gold standard surgical treatment of chronic anal fissure is lateral internal sphincterotomy which lowers the resting anal pressure and effectively heals the majority of fissures. Local application of 0.2% glyceryl trinitrate ointment has been used as an agent for chemical sphincterotomy, causing temporary alleviation of sphincter spasm and allowing the fissure to heal without compromising the anal continence. The aim of the present study was to compare the results of surgical sphincterotomy with that of local 0.2% glyceryl trinitrate ointment in the treatment of chronic anal fissure. Seventy adult patients between the age of 18 and 50 years with chronic anal fissure were randomized in a prospective trial to receive either surgical sphincterotomy or 0.2% glyceryl trinitrate ointment locally. Patients were followed up at 2 weeks' interval for 10 weeks. Symptom relief, fissure healing and continence scores were the outcomes assessed. Six patients were excluded for protocol violations. Surgical sphincterotomy was significantly more effective in providing pain relief and was associated with significantly better fissure healing rates at 6 weeks and 10 weeks (both p<0.001). There were substantial problems with compliance in ointment group related to slow healing and longer time needed for symptomatic relief. Minor incontinence was 6% in sphincterotomy group and none in ointment group (p>0.05). Considering early symptomatic relief, rapid fissure healing and better patient compliance surgical sphincterotomy is the treatment of choice for chronic anal fissure.

Bangladesh College of Physicians and Surgeons has been the pioneer in developing post-graduate medical education in this country. The curriculum offers guidelines for selecting versatile candidates to become future specialist, training particulars and learning outcomes and set criteria expected of them at the exit. In general, the curriculum is the guideline for the trainees and training facilities including the assessment system to fulfill the conditions to facilitate creation of specialist in different disciplines To document the hard works done by the fellows in last 50 years to establish curriculum in different specialities. All the available data regarding development of curriculum found are analyzed to document the struggles did previously to develop curriculum in different specialities of BCPS. FCPS part-1 syllabus was printed in different subject in the year 2000. Between 2000-2005 most of the subject developed printed part-I syllabus. Changes in the structure of postgraduate medical education and training of the BCPS was initiated in 2012 by holding a workshop to discuss the way forward with participation of experts from the Royal College of Physicians and Surgeons of Glasgow, College of Physicians and Surgeons of Pakistan, experts from the USA together with leading members of the Faculties of BCPS. This resulted in the decision that individual Faculties need to develop a curriculum. To ensure competency based training a common frame work was approved by the Council of the College in 2016. In 2017 another important change was approved that FCPS course will be for 5 years from January 2020. On the back ground of those decisions of the council curriculum and log book development committee work hard to developed new curriculum and log book. Several Workshops involving leading Faculty members on the development of the curriculum were held in the following months starting on 2019. In the year 2020 and 2021 this committee with the help and different faculties and administration able to published new curriculum in 42 specilities. Dynamicity of the curriculum makes it possible to incorporate recent advancements in the subject. This updated curriculum includes relevant new developments in different specialties. J Bangladesh Coll Phys Surg 2022; 40: 74-77

Background: Modern surgical techniques and improved preoperative care has reduced both morbidity and mortality of colorectal surgery but the role of mechanical bowel preparation is recently disputed. Primary colonic anastomosis without mechanical bowel preparation is still considered unsafe. Objective: One of the objectives of this study was to evaluate pre-operative mechanical bowel preparation in preventing anastomotic and wound dehiscence in elective colon and rectal surgery. Methods: Fifty patients who were included in this study were randomly divided into two groups (group A & Group B). Group A was the preparatory group and Group B was the non-preparatory group. In preparatory group oral poly ethylene glycol was used for mechanical bowel preparation and in non-preparatory group no bowel preparation done. All patients were operated on by qualified surgeons and followed up for outcome and collected data were analyzed. Results: 80% of the Patients in Group A had adverse effects of bowel preparation like nausea, vomiting, blotting, loose motion and precaution had to be taken for them. All the patients of both groups were given per-operative antibiotics whereas 24 patients of Group A and 23 patients of Group B were given transfusion. 15(60%) patients of Group A had developed post-operative surgical infectious complications. The majority number of patients of Group A had been suffered from surgical site infection (10, 40%) followed by Anastomotic Leak, Intra-abdominal abscess and Peritonitis whereas in Group B 10(40%) patients developed surgical complications. Conclusion: Mechanical bowel preparation before elective colon and rectal surgery is not so effective in preventing complications and without any mechanical preparation of the bowel colorectal surgery can be done safely. Journal of Surgical Sciences (2017) Vol. 21 (2): 105-109

Port site infection(PSI) in laparoscopic surgery is not very uncommon. The main aim of this study was to assess the causes of port site infection and its management. This retrospective descriptive study was conducted on 48 patients from March 2019 to December 2020 who develop port site infection after laparoscopic cholecystectomies. Operation notes were analyzed; and swabs were taken for culture & sensitivity. Exploration and wound debride- ment with excisional biopsies were done under local anesthesia for all patients. All patients were followed-up for one year postoperatively. Factors as gender, site of infected port, types of microorganism, acute versus chronic cholecystitis, type of infection (superficial or deep infection) and intraoperative spillage of stones, bile or pus were analyzed . Age of the patients ranged from 15 years to 60 years and the mean age was 32.4 years. The female to male ratio is 2.2:1. Among the subjects, 56.25% patients suffered from acute and 43.75% suffered from chronic cholecystitis. 35.42% had a history of spillage of bile or stones in the abdomen. Considering the site of infection, 33.33% had only umbilical port site infection, 18.75% had only epigastric port infection and 47.92% had multiple port infection. 58.33% suffered from superficial infection and others had deep site infections. Histopathology reports showed granulomatous infection in case of 37.5% patients. So, special consideration should be taken in chronic deep surgical site infection as Mycobacterium tuberculosis could be the cause. BSMMU J 2021; 14(4): 99-103