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Background and Objective: Currently, laparoscopic appendectomy (LA) is widely practiced for the management of acute appendicitis (AA). The application of laparoscopic technique for appendectomy is expanding very rapidly and now performed in almost all major cities and tertiary level hospitals. This study addressed to determine the outcomes of laparoscopic appendectomy in our surgical setup at Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorder (BIRDEM).

Congenital absence of the vermiform appendix is a rare condition in human that many well-experienced surgeons have never seen. The fact that congenital absence of the vermiform appendix has been reported on several occasions confirms its existence and should be kept in mind. A thorough and meticulous search of the entire ileocecal region and mobilization of the cecum and ascending colon should be carried out before the diagnosis is made. But, it should also be kept in mind that early cessation of appendiceal anlage can result in very tiny ones. DOI: http://dx.doi.org/10.3329/bccj.v1i2.17207 Bangladesh Crit Care J September 2013; 1 (2): 109-110

Background: Fournier’s gangrene is the necrotising fasciitis of the genitalia and perineum, with associated poly microbial infection. Evidence based data in the very recent years suggest that it is associated with significant and potential risk of organ failure or death.Aim: This study was designed to be conducted among the patients suffering from Fournier’s gangrene with a view to assess the probable prevalence rate of potentially adverse clinical consequences during course of treatment, overall mortality and to observe the microbiological pattern in our surgical practice.Method & materials: This cross sectional study was conducted among the 69 patients of Fournier’s gangrene in BIRDEM General Hospital, Dhaka, Bangladesh from Jan 10.2013 to Sept 01 .2016, using the purposive sampling method.Results: The results of this study reflects that majority (43.4%) of the study population were in 51 to 60 years age group( Mean age 43±1.7 years) in study population. By using the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score, it was found that in most of the patients (approx 56.5%), a suspicious score ranging 06-08 was observed and only in 10.1% patients, a specific score of ?08 was observed. In 27.5% patients systemic complications like DIC, ARDS, MODS, MSOF and severe sepsis were observed in 1.4%, 4.3%, 10.1%, 4.3% and 5.7% cases respectively. Mortality rate was approximately 4.3%. Majority (84.1%) of the patients were associated with type 1 (Polymicrobial) bacterial infection, whereas in case of 15.9% patients, it was associated with type 2 (Monomicrobial) infection. Escherichia coli was the most frequently observed micro-organisms associated with approximately 39.1% of all cases. S. aureus, Staphylococcus pyogenes, Enterococci species, E.coli and Pseudomonas species were recorded to be associated with 17.4%, 27.5%, 21.7%, 39.1 and 10.1% cases respectively.Conclusion: This study suggests that Fournier’s gangrene is associated with significant systemic complications. Poly microbial infections are most predominant and E coli infection was commonest organism involved.Bangladesh Crit Care J March 2017; 5(1): 28-32