Purpose: The purpose of the study was to see the outcome of primary anastomosis and enterostomy in jejunoileal atresia, to identify the complications associated with these surgical procedures and to find out a preferable surgical option for the complicated atresia. Methods: This prospective study was carried out in the Department of pediatric Surgery, in a tertiary pediatric hospital during the period of 5 years (July 2006 to June 2011). The study included neonates of both sexes, who were per operatively diagnosed as jejuno-ileal atresia. We excluded the patients of jejunoileal atersia with associated major anomaly like complex ARM, gastroschisis, omphalocele etc. Results: During this study period, a total 176 patients were diagnosed as jejunoileal atresia. Twelve of them were excluded due to presence of major associated anomaly. So the sample size was 164. Resection and primary anastomosis were done in 132 jejunoileal atresia with or without gangrene. Enterostomy were done in 32 cases, complicated by perforation of proximal segment with gangrene and peritoneal soiling. Mortality was higher after primary anastomosis in complicated atresia but much better than enterostomy. Complications were also more frequent and troublesome after enterostomy. Conclusion: Primary anastomosis gave better outcome in all types of jejuno-ileal atresia with or without complication which reduce the post operative morbidity and mortality.

Repairs of cleft lip and simultaneous closure of cleft hard palate with vomer flaps are safe in patients with UCLP, and it makes easy the closure of the soft palate later on and decreases the chance of oronasal fistula.

Background: Meconium ileus is a common cause of neonatal intestinal obstruction. Various surgical procedures are in practice for uncomplicated meconium ileus. Bishop Koop ileostomy allows distal passage of gut content and uses the distal absorptive area. T tube ileostomy avoids the need for gut resection and formal closure of stoma. The aim of this prospective interventional study was to compare the outcome of T-tube ileostomy and Bishop Koop ileostomy for the treatment of uncomplicated meconium ileus.

Background: Many approach have been tried for management of vestibular fistula, most of them have post operative complication like wound infection, wound dehiscence, more hospital stay which compromise the functional out come and aesthetic appearance of the perineum. Objective: The aim of present study was to see the effectiveness of Transfistula Anorectplasty (TFARP) Which was required minimal dissection without interruption of perineal body and perineal skin. Methodology: The cross sectional study on 43 patients with vestibular fistula were held in Dhaka Shishu Hospital from September 2008 to April 2010. Patients were operated after obtaining informed consent and standard bowel preparation. Data on demographics, operation time and postoperative complications were collected as a questionnaire and plotted on Microsoft Excel and analyzed systematically by SPSS version 17. Patients were followed up for a period of 2½ months postoperatively. Results: There is no statistical deference in patient population regarding age, geographical distribution, and clinical presentation. Mean operation time was 76.5 min for TFARP and 84.34 min for ASARP. Two (02) cases had wound infection after TFARP operation and 11 patients after ASARP operation. One patient develops partial wound dehiscence after TFARP and was healed after conservative treatment within 7 days. On the other hand 05 patients developed partial wound dehiscence and 04 patients developed complete wound disruption after ASARP which were also treated conservatively need more than 2 weeks on an average. Mean hospital stay were 6.45 days after TFARP operation and mean hospital stay were 7.87 days after ASARP operation. 20 neonates and infant who were treated by TFARP operation have good bowel movement without laxative and symmetrical anal contraction after stimulation. Conclusion: TFARP is an operation produce less morbidity and is more effective procedures and superior procedures than that of ASARP operation and give aesthetic appearance of the perineum

The purpose of the study was to see the short-term outcome of simultaneous repair of cleft lip and cleft hard palate with vomer flap against cleft lip repair alone in patients with unilateral complete cleft lip and palate (UCLP). A prospective observational study was carried out in 35 patients with unilateral complete cleft lip and palate who under-went cleft lip and cleft hard palate repair with vomer flaps simultaneously. After 3 months, cleft soft palate was repaired. During 1st and 2nd operations, the gap between cleft alveolus and posterior border of the cleft hard palate was measured. Postoperative complications, requirement of blood transfusion during the operation, and duration of operations were also recorded. Simultaneous repairs of cleft lip and closure of cleft hard palate with vomer flaps are easy to perform and are very effective for the repair of cleft lip and palate in UCLP patients. No blood transfusion was needed. Gaps of alveolar cleft and at the posterior border of hard palate were reduced remarkably, which made the closure of the soft palate easier, decreased operation time, and also decreased the chance of oronasal fistula formation.

Purpose: Infantile Hemangioma is a common vascular tumor of infancy and children. Although the lesions involute, the results are unpredictable and the time taken is variable. Responses to commonly used drugs like corticosteroid are not satisfactory due to variable effectiveness. There are also hazards of surgical intervention. The aim of this study is to compare the oral propranolol & prednisolone for IH treatment. Methods: In this study 104 patients were included. They were divided into 2 groups by systematic sampling method. In Group-A 52 patients were treated with oral propranolol and in Group-B 52 patients with oral prednisololne as per the protocol at a dose of 2mg/kg/day in two divided doses. Measurements of the size (directly measured by soft flexible rubber tape and calipers) and color assessment (image based by Adobe Photoshop software) were recorded before starting of the treatment. Follow up was done on 15 th day, after 1 st , 2 nd , 3 rd and 4 th month respectively. Evaluation of percentage of regression of size and color clearance, adverse effects and treatment cost was done at each follow up. Regression in the size and color clearance of IHs was clinically assessed. Data were analyzed with the help of SPSS. P value of < .05 was considered significant. Results: In group-A 42(80.76%) had an excellent response, compared to group-B only 5(9.61%).In group-A, 40(76.92%) had an excellent color clearance, compared to group-B where only 03(05.76%). Regarding adverse effects in group-A, only 08 children (15.38%) complained of mild adverse effects which were self-limiting compared tothat of group-B (47,90.38%). In group-A average treatment cost was 165tk/ patient and in group-B 580tk. During follow up in group-A one case relapse was seen, in group-B 8 patient. Conclusion: Propranolol was safe, more effective and economic than oral prednisolone.

Background: Primary reduction of swollen oedematous viscera in gastroschisis is difficult, results abdominal compartment syndrome and associated with poor prognosis. Use of umbilical cord flap reduce intra-abdominal pressure and results batter outcome.Objective: This retrospective study was done to evaluate the outcome of gastroschisis patient in whom umbilical cord flap covering was given.Methods: Clinical records of the patients of gastroschisis were evaluated retrospectively during the period of July 2014 to June 2017, whom the abdominal wall defect ware covered with umbilical cord flap. After reduction of bowel into the abdomen as much as possible without pressure, the remaining eviscerated intestine is covered by the longitudinally split umbilical cord if the adequate length was available.Results: Total 108 neonates were admitted with gastroschisis. Out of them, in 27 neonates umbilical cord flap were used. In 16 cases, abdominal defect was healed completely. Eight patients developed ventral hernia required secondary repair operation when 1 year 6 months old. All 24 survived children were followed up for 6 months to 2 years 6 months. Mean follow up time was 1.7 ±1.3 years.Conclusion: Umbilical cord flap coverage could be a better technique in repair of gastroschisis with oedematous gut, where postoperative NICU facilities is limited.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 47-50

Turmeric is an important spice crop of Bangladesh. A field experiment was conducted at farmer’s field of North Jhatibunia, Mirzagonj, Patuakhali during April, 2015 to February, 2016. The study was performed to find out the effect of green manure and nitrogenous fertilizer on the growth and yield of turmeric (BARI Halud-2), in coastal region of Bangladesh. In this study different combinations of green manure along with nitrogenous fertilizer were used. There was eight treatment combinations (viz. 7 ton biomass/ha + 100 kg N/ha, 7 ton biomass/ha + 80 kg N/ha, 7 ton biomass/ha + 60 kg N/ha, 7 ton biomass/ha + 40 kg N/ha, 7 ton biomass/ha + 20 kg N/ha, 7 ton biomass/ha, 100 kg N/ha and control). The highest number of leaves per plant (11.67) were recorded by the combined application of 7 ton biomass/ha along with 100 kg N/ha. The highest plant height (80.70 cm) and the longest leaf length (47.33 cm) were recorded by the application of 100 kg N/ha. The highest number of tillers per plant (7.67), maximum number of primary rhizomes per plant (9.00), maximum fresh weight of clump (189.67 g), highest fresh weight of roots (48.01 g), maximum fresh weight of rhizomes (277.70 g), maximum dry weight of clump (20.01 g), highest dry weight of roots (9.25 g), maximum dry weight of rhizomes (67.50 g) and maximum yield of fresh rhizome per hectare (6.64 tons) were recorded by the combined application of 7 ton /ha biomass+ 40 kg N/ha. Highest number of secondary rhizomes per plant (17.00) and maximum number of tertiary rhizomes per plant (7.00) were recorded by the application of 7 ton biomass/ha + 60 kg N/ha. With a few exception, the best performance in terms of growth and yield of turmeric were found from the combination of 7 ton biomass /ha + 40 kg N/ha.