Background: Urethrocutanous fistula after hypospadias surgery repair is the most common complication and remains a frustrating problem for the surgeon and the patient. The problem is exacerbated because the urethrocutanous fistula may recur which adds more demands surgery. Aim: To evaluate the use of buccal mucosal patch graft for treatment of recurrent post hypospadias repair urethrocutanous fistula. Patients and methods: Between January 2018 and August 2019 at Al- Shaheed Ghazi Al- Hariri Hospital in Medical City Complex in Baghdad. 10 boys with recurrent urethrocutanous fistula were included in this study. Their age ranged between 5-12 years. All were repair using a buccal mucosal graft with dartos fascia as an interposed reinforcing layer. Results: Nine out of 10 patients who involve in this study showed complete healing of their fistula, with no recurrence of the fistula during 6 months follow up period postoperatively and also no donor site complication. Conclusion: The Oral mucosal patch graft is simple and easy procedure that can be used for treatment of recurrent urethrocutanous fistula, it provided extragenital tissue for an area that had being fibrous from previous surgery. It shows to reduce the chance of recurrence of the urethrocutanous fistula with minimal or no donor site morbidity.

Introduction: Most epidemiological data concerning low back pain (LBP) are related to developed and industrialized countries but little information about LBP in the general population in developing and low-income countries. Back pain affects 60-80% of people at some time in their lives. Acute low back pain is one of the most common reasons for adults to see a family physician. Although most patients recover quickly with minimal treatment, proper evaluation is imperative to identify rare case of serious underlying pathology. Aim of the study: The aim of the study is to evaluate the different causes of low back pain, occupational and risk factors, association with age and sex of the patient and their life styles. Materials and Methods: The present study is a retrospective study of 300 patients of low back pain between the age group of 31-70 years of both sexes who were admitted and treated at Dept. of Forensic Medicine, Kushtia Medical College Hospital, Kushtia, Bangladesh from January 2020 to December 2020. The information was collected from the patients regarding their occupation, education, obesity, smoking, tuberculosis, diabetes, alcohol consumption, osteoporosis, Osteoarthritis and history of trauma. The provisional diagnosis of cases was done and confirmed radiologically. A proforma was prepared and the patient’s age, sex, duration of symptoms, place of living and the cause for low back pain was noted. A neurological examination of the lower limbs was performed. Results: The author tabulated 300 patients of low back pain into four categories according to age and noted the number of cases in each group. The highest number of cases (124) is observed in the age group of 31-40 years (41%) and the lowest number of cases (45) is observed in the age group of 51-60 years (15%). All patients were thoroughly interrogated (occupational, trauma, infection, diabetes mellitus, smoking, alcohol and medication history), subjected to a rigorous clinical examination and a ....

Background: Bile duct injury is severe and potentially life threatening complication of cholecystectomy. It ruins the patient physically, mentally, socially and financially. The incidence of bile duct injury is alarming in our country. Management of such patients needs to be explained. Methods: It is a cross-sectional descriptive study carried out in the Department of Surgery, Mymensingh Medical College Hospital, Mymensingh, Bangladesh during the period January 2018 to July 2020. A total of 70 patients diagnosed as bile duct injury were included in the study. Bile duct injury that occurs during liver or pancreases surgery or accident was excluded. Data were collected using a predesigned data collection sheet and analyzed using computer software SPSS (Statistical Package for Social Sciences) version 22. Results: Young and female patients suffer more 44(62.9%) than male. Occurrence was common during laparoscopic cholecystectomy 42(60%). Most of bile duct injury occur when cholecystectomy done on acute condition of gall bladder 59(84.3%). Most of bile duct injury patient came to specialized center after several week of injury with billiary stricture 54 (77.14%) with jaundice, some patients presented with abdominal pain 48(68.6%), abdominal distension 18(25.7), biliary peritonitis 16(22.9) and biliary fistula 14(20%). Patients with bile duct injury were evaluated by USG, liver function test, ERCP and MRCP. Maximum BDI patients were Bismath Type II 32(45.7%) and Bismath Type III 18(25.7%). Out of 70 cases USG performed 68 cases (2 patients repair at the time of surgery) and these investigations provided valuable information about condition of biliary tree, hepatic parenchyma and ductal system also intra-abdominal collection. 14 patients were done ERCP. Billiary stricture in different level seen among most of the patients (10). Bile leakage seen among 4 patients and all were underwent ERCP stenting. Conclusion: The present study showed that bile duct injury occurs.......

Background: Left atrial enlargement (LAE) has been proven to be significantly related to stroke and cardiovascular diseases. Previous studies have shown a link between Left atrial enlargement (LAE) with the increase in the risk of stroke and cardiovascular diseases (CVD). Bangladeshi data is lacking on the exact prevalence of LAE. Aims and Objectives: To study the prevalence of LAE and its associated risk factors. Materials and Methods: Hundred patients having were studied in the Department of Vascular Surgery, Bangabandu Sheikh Mujib Medical University (BSMMU), and Dhaka, Bangladesh from January 2020 to December 2020. After a complete physical examination, echocardiogram was performed in all the patients. In present study LAE is defined if the LA diameter is more than 4.0 cm in men and 3.8 cm in women. We performed multivariable logistic regression analysis to identify risk factors for LAE. Results: Prevalence of LAE was 8%. The prevalence of LAE was higher in men (9.37%). On multivariable logistic regression analysis advancing age (OD;1.034), increased systolic blood pressure (SBP) (OR: 2.862), increased diastolic blood pressure (DBP) (OR: 1.32), abnormally high BMI (OR: 3.721), increased prevalence of diabetes (OR: 1.245), increased left ventricular myocardial index (LVMI) (OR: 1.023), and decreased left ventricular ejection fraction (LVEF), decreased heart rate (HR), and decreased estimated glomerular filtration rate (eGFR) were found to be the major risk factors of LAE. Conclusion: A significant number of patients had LAE. Among the risk factors advancing age, increased SBP, increased BMI, presence of diabetes mellitus, increased LVMI, decreased eGFR, decreased LVEF, and decreased HR were more common.

Abstract: Worldwide, one in eight deaths is due to cancer. Projections based on the GLOBOCAN 2012 estimates predict a substantive increase new cancer cases per year by 2035 in developing countries if preventive measures are not widely applied. According to the World Health Organization (WHO), millions of lives could be saved each year if countries made use of existing knowledge and the best cost-effective methods to prevent and treat cancer. Therefore, the aim of this study is to estimate a provisional budget against cancer in low and middle incomes countries, according the GNI-PPP, the cancer incidence and the number of population. Economically country classification is determining with the Gross national income (GNI), per capita, Purchasing power parity (PPP), according the administrations of the International Monetary Fund (IMF), the World Bank (WB) and the Central Intelligence Agency (CIA). Cancer incidence data presented are based on the most recent data available at IARC. However, population compares estimates from the US Bureau of the Census. The provisional budget is establishing among the guidelines developed by WHO for regional and national cancer control programs according to national economic development. Provisional budget against cancer is estimated to 4,979.580 (thousands of U.S $) for a population of 200,108 persons in Samoa.

Abstract: Worldwide, one in eight deaths is due to cancer. Projections based on the GLOBOCAN 2012 estimates predict a substantive increase new cancer cases per year by 2035 in developing countries if preventive measures are not widely applied. According to the World Health Organization (WHO), millions of lives could be saved each year if countries made use of existing knowledge and the best cost-effective methods to prevent and treat cancer. Therefore, the aim of this study is to estimate a provisional budget against cancer in low and middle incomes countries, according the GNI-PPP, the cancer incidence and the number of population. Economically country classification is determining with the Gross national income (GNI), per capita, Purchasing power parity (PPP), according the administrations of the International Monetary Fund (IMF), the World Bank (WB) and the Central Intelligence Agency (CIA). Cancer incidence data presented are based on the most recent data available at IARC. However, population compares estimates from the US Bureau of the Census. The provisional budget is establishing among the guidelines developed by WHO for regional and national cancer control programs according to national economic development. Provisional budget against cancer is estimated to 42,148.788 (thousands of U.S $) for a population of 11,901,484 persons in Rwanda.

Abstract: Introduction: Pleomorphic adenoma is a benign neoplasm that develops at the expense of the salivary gland. It evolves without symptoms; the reason why late consultations are often observed. The size of its volume can have an important functional implication. Observation: A 22 years old patient was referred by a dental surgeon for a palatal swelling evolving for two years. Intraoral examination presented an ovoid palatal mass not crossing the median line. It was covered with normal mucosal. The swelling on palpation was non tender and with a firm consistency. The scanner presented a well limited homogenous lesion located at the palate. Excision was done under general anaesthesia. Palatal silicone plate was used to protect the operated wounds. Post operation evolution was simple. Discussion: Pleomorphic adenoma is one of the most frequents benign salivary glands tumours. It is relatively rare intraorally, but when it occurs it is mostly located at the palate. It is recommended to use a palatal plate after surgery to facilitate healing and promote oral functions like phonation, as well as feeding. However, most often we are faced with unforeseen events that do not permit us to follow the usual pattern. Conclusion: Oral surgeon must be able to adapt to any situation in order to provide quality services regardless of the context.