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Papers by Abdullah Al Farooq

Asian Journal of Pediatric Research, Oct 3, 2020

Aims: While the developed world has significantly reduced mortality from surgical conditions in c... more Aims: While the developed world has significantly reduced mortality from surgical conditions in children, there is lack of adequate data on the outcome of children's surgical conditions in the developing world. This study aims at assessing the spectrum of mortalities from children's surgical conditions in a low-middle income country (LMIC). Methods: Mortality data were collected for a period of 12 years (2008 to 2019) among 0 to12-year old children to analyse the diseases which had higher mortality trends, age-group specific mortality trends and categorize those according to body system. Results: Among a total of 30,301 admitted children, 1228 (4.05%) patients died. Among them 53.01% were neonates, 20.28% were infants and 26.71% were children. Male to female ratio was 1.95:1. Mortality from neonatal surgical conditions was 24.21%. Infant mortality rate was 5.65%

Journal of Paediatric Surgeons of Bangladesh, Jul 16, 2014

Spontaneous bile duct perforation (SBDP) is a relatively rare condition. The cause of SBDP is sti... more Spontaneous bile duct perforation (SBDP) is a relatively rare condition. The cause of SBDP is still speculative. Presentation , site of the perforation and management varies. Pancreatic lithiasis (PL) is a very rare entity in childhood. Biliary perforation on the background of PL is still a rare event. This is a case report of 10 years old girl presented as acute abdomen with theclinical diagnosis of acute on chronic pancreatitis, for which conservative treatment followed by laparotomy was carried out.Common bile duct (CBD) perforation was found near it's junction with cystic duct. T tube was instituted and a drain was kept in situ. Postoperative period (POP)was uneventful. T-Tube Cholangiogram was carried out on 12 th postoperative day(POD) that showed dye had passed to duodenum easily and patency and caliber of the CBD was found normal. Multiple stones were noted in the vicinity. No apparent cause of CBD perforation was found. After one month, in follow up visit the patient was found alright. She was asked to come after 3 months for further evaluation. The plan is to evaluate the patient's conditions clinically and biochemically and to do an MRCP to see details of pancreatic pathology. As SBDP in children with PL is a rare condition, high index of suspicion is needed for early diagnosis and proper management of such patient.

Journal of Chittagong Medical College Teachers' Association, Aug 20, 2017

Background: The postoperative complications of urethroplasty in hypospadias surgery still remain ... more Background: The postoperative complications of urethroplasty in hypospadias surgery still remain a great challenge to Paediatric urologists. The aim of the study was to find out the cause and incidence of meatal stenosis and stricture urethra following urethroplasty and to solve the postoperative complication. Materials and methods : This Prospective study was carried out in the department of Paediatric Surgery, Chittagong Medical College Hospital from April 2013 to October 2014 for a total of 19 months. A total of 50 hypospadias patients were selected for this study. After urethroplasty, outcome was assessed in terms of meatal stenosis and stricture urethra in the study period. Results : Meatal stenosis occurred in 5 patients in first follow up, which responded to regular dilatation in 3 patients in second follow up and till the end of third follow up, 2 patients were continuing regular meatal dilatation. In this study, urethral stricture occurred in 2 patient (4%) in second follow up, which was treated with regular urethral dilatation under general anaesthesia. Conclusion : It is evident from this study that, meatal stenosis is not very uncommon after urethroplasty which can very easily be treated by regular meatal dilatation. Urethral stricture, though not common, can also be treated by regular urethral dilatation under General Anaesthesia (GA).

Journal of Chittagong Medical College Teachers' Association, Nov 2, 2014

Journal of Chittagong Medical College Teachers' Association, 1970

Chattagram Maa-O-Shishu Hospital Medical College Journal, Oct 28, 2013

Background: Carcinoma pancreas is being diagnosed increasingly with the help of conventional imag... more Background: Carcinoma pancreas is being diagnosed increasingly with the help of conventional imaging like ultrasonography (USG), computerized tomography (CT) scan and magnetic resonance imaging (MRI).Imaging also gives the opportunity to assess resectability. In our country MRI and CT scan are not widely available and most of the pancreatic carcinoma is too advanced for curative surgical resection when diagnosed. These are unresectable carcinoma pancreas (UCP). Objectives: To evaluate the efficacy of imaging in diagnosing carcinoma pancreas and to assess resectability after comparing them with peroperative findings. Methods: This retrospective study was carried out in the department of Hepato-Biliary-Pancreatic Surgery in Bangladesh Institute for Research and Rehabilitation in Diabetic Endocrine and Metabolic disorders (BIRDEM) hospital, Dhaka, Bangladesh from July 2004 to June 2006 (2 years). After laparotomy findings and histopathological confirmation 50 patients were labeled as UCP. Among 50 patients male were 28 & female patients were 22. Imaging modalities used before surgery was assessed and compared with per operative findings. USG were done in all patients and CTscan in 45 patients. MRI was done in 08 patients suspected clinically as pancreatic carcinoma where USG /CT scan had failed to reach a conclusion. Findings of the various imaging studies regarding diagnosis and unresectability were compared with per operative findings. Results: USG was able to diagnose 42 (84%) pancreatic carcinoma patients with unresectibility in 29 (69%). Forty five patients (90%) were diagnosed by CT scan and could label 38 (84.44%) as unresectable. MRI was 100% accurate to diagnose and label the entire 08 patient as unresectable carcinoma pancreas. Cumulative multimodal preoperative imaging was 91.33% accurate in diagnosing carcinoma pancreas and could tell the features of unresectibility in 73.59% patients. Conclusion: CT scan should be the primary imaging modality for diagnosing pancreatic carcinoma and its resectability. MRI is very promising for diagnosing and assessing UCP. Multimodal imaging is better than single imaging.

Journal of Chittagong Medical College Teachers' Association

Intussusception is a common cause of intestinal obstruction in young children and is a common eme... more Intussusception is a common cause of intestinal obstruction in young children and is a common emergency in infants and children. Hydrostatic reduction of intussusception is a less invasive procedure for both diagnosis and treatment of it. We describe our experience with hydrostatic reduction of intussusception. A retrospective review of the patients of Intussusception admitted in the department of Pediatric Surgery Chittagong Medical College Hospital (CMCH) Chittagong, Bangladesh from January 2009 to December 2013 was done. Patients underwent hydrostatic reduction were evaluated separately. Data were analyzed with regard to success and failure of hydrostatic reduction, necessitating laparotomy, complication and mortality. There were 231 patients of Intussusception. Age range was lmonth to 15 years with median age of 8 months. Male to Female ratio was 2.9:1. Mean duration of presentation was 40 hours after onset of symptoms. Hydrostatic reduction was attempted in 142 patients and was...

Journal of Chittagong Medical College Teachers' Association

Intussusception is a common gastrointestinal emergency in children and appears to have a somewhat... more Intussusception is a common gastrointestinal emergency in children and appears to have a somewhat different clinical spectrum in developing countries. Its etiology is still unclear, but a link to infective agents and viruses has been highlighted. This study aimed to assess the gender and seasonal variation and the disease load of intussusception in Chittagong Medical College and Hospital (CMCH). A retrospective review of the patients of Intussusception admitted in the department of Pediatric Surgery, CMCH, Chittagong; Bangladesh from January 2009 to December 2013 was done. Help was also taken from yearly departmental audits of 2009 to 2013. Data were analyzed with regard to occurrence, seasonal variation, gender variation, diagnosis, treatment and mortality. Statistical analysis was performed by the chi-square test, and mean and percentage values were calculated. P<0.05 was considered to be statistically significant. There were 231 patients of Intussusception. Age range was 1mont...

Journal of Chittagong Medical College Teachers' Association

Midgut volvulus with gangrene is not a rare event. With normal rotation, the mesentery is broad a... more Midgut volvulus with gangrene is not a rare event. With normal rotation, the mesentery is broad and fixed, but the narrow pedicle formed by the base of the mesentery in malrotation of the gut predisposes the midgut to clockwise twisting from the duodenum to the transverse colon. Excessive length of the mesentery, or a point of adhesion at the convexity of the loop may act as an axis for the loop .The actual inciting mechanism is unknown but various possibilities, including unusual movement of the torso, abnormal intestinal peristalsis, or segmental bowel distention, have been suggested. This is a grave surgical emergency to save the life of the patient. We are reporting a case of midgut volvulus with herniation of the ileum into the right paraduodenal recess after blunt abdominal trauma (BAT). A 8 years old boy complaints of abdominal pain, vomiting, and distension of the abdomen following diving to a pond. Abdominal x-ray and USG, CBC, Serum Electrolyte were carried out to evaluate...

Journal of Chittagong Medical College Teachers' Association

Infantile hypertrophic pyloric stenosis (IHPS) is the most common cause of gastric outlet obstruc... more Infantile hypertrophic pyloric stenosis (IHPS) is the most common cause of gastric outlet obstruction in infants with a prevalence of 1.5 to 4.0 per 1000 live births. It has been suggested that the incidence is increasing. USG is the most useful method for diagnosis supplanting physical examination and pyloromyotomy is the time honored treatment option. A retrospective review of the patients of IHPS admitted in the department of Pediatric Surgery, Chittagong Medical College Hospital (CMCH) Chittagong, Bangladesh from January 2008 to December 2012 was done. Help was also taken from yearly departmental audits of 2008 to 2012. Data were analyzed with regard to occurrence, seasonal variation, gender variation, presentation, diagnosis, treatment and outcome. Statistical analysis was performed by the chi-square test, and mean and percentage values were calculated. P<0.05 was considered to be statistically significant. There were 42 patients of IHPS. Age range was 5 days to 1 year 8 mon...

Journal of Chittagong Medical College Teachers' Association, 2011

Introduction : Malrotation is a common anomaly in the pediatric age group which includes a wide ... more Introduction : Malrotation is a common anomaly in the pediatric age group which includes a wide spectrum of anomalies of Rotation. Both acute and chronic presentations are common. Atypical malrotation not having all the features of classic mal Rotation is frequently found which a diagnostic dilemma and the management varies from centre to centre. Materials and Methods : The medical records of all patients with symptomatic malrotation, who underwent surgery between July 2001 to June 2011, were retrospectively reviewed. Patients’ presentation, management, operative findings and complications were evaluated. Results : 68 patients underwent surgery for malrotation at a median age of 2 years. Male to female ratio was 2:1. 28(41%) presented with acute symptoms and 40(59%) with chronic symptoms. 54(79%) patients had vomiting, 36 (%3%) presented with abdominal distension, 19(28%) had recurrent abdominal pain. Diagnostic laparoscopy was done in 7(10%) patients. Ladd’s band was found in 16(2...

Aims: Injuries are becoming major causes of morbidity and mortality throughout the world and onet... more Aims: Injuries are becoming major causes of morbidity and mortality throughout the world and onethird of the injured patients have abdominal injuries. The aim of the study was to analyze epidemiological characteristics of blunt abdominal injuries in children at a tertiary government facility in a lower middle-income country. Study Design: Retrospective chart review study. Place and Duration of Study: Department of Pediatric Surgery, Chattogram Medical College Hospital, between January 2017 and June 2020. Methods: This was a tertiary-level hospital-based study on children admitted with blunt abdominal injuries. Epidemiology, mechanism of injury, other associated injury, organ involvement, treatment and outcome were analyzed. Original Research Article Chowdhury et al.; AJRS, 5(1): 19-30, 2021; Article no.AJRS.65066 20 Results: Among 309 patients, male to female ratio was 3.48:1. Age ranged from 32 days to 12 years (mean 7.29 ± 3.05 7 years). Majority were school-age children (183, 59....

Asian Journal of Medical and Biological Research, 2020

Foreign body (FB) ingestion is common in children worldwide. Type of FB ingestion varies among cu... more Foreign body (FB) ingestion is common in children worldwide. Type of FB ingestion varies among cultures and countries. We retrospectively reviewed all patients of foreign body ingestion who were admitted in Department of Pediatric Surgery, Chittagong Medical College Hospital from January 2017 to December 2019 (total 3 years). Age, Sex, type of foreign body, hospital stay, management and outcome were analyzed. A total of 91 children were admitted with ingestion of FB during this period; male 61, female 30 (male to female ratio 2:1). Age ranged from 3 months to 12 years (median 3.5 ± 3.8 years). Fifty eight percent were less than 5 years old. Children ingested 21 different types of FB; however ingestion of coin was most common (24 patients, 26.37%) followed by different types of pins (19 patients, 20.88%), nail (6 patients, 6.59%), battery (5 patients, 5.49%), screw (5 patients, 5.49%), needle (4 patients, 4.40%), ring (4 patients, 4.40%) and others (18 patients). Sharp object ingesti...

Purpose: To evaluate the outcome of prenatally diagnosed posterior urethral valve (PUV) patients ... more Purpose: To evaluate the outcome of prenatally diagnosed posterior urethral valve (PUV) patients in our setup where fetal interventions are not available. Methods: This prospective study included 24 PUV patients (July 2007 to December 2012), who were diagnosed prenatally but had no prenatal interventions and delivered in our center. Within 24 hours after birth, all of them had urinary ultrasonography (USG). Voiding cystourethrography (VCUG) and renogram were done in the second week and cystoscopy with valve ablation during the same admission period. Patients were followed up regularly after cystoscopic fulguration. Clinical features, treatment, and outcomes were analyzed. Results: Predominant clinical features were renal failure and urinary ascites. Eleven patients (45.8%) had bilateral vesicoureteric reflux (VUR) of different grades. Eight patients (33.3%) had decreased renal cortical thickness (<10 mm). All patients underwent cystoscopic fulguration except three (expired before fulguration). Four patients (16.6%) needed cutaneous vesicostomy along with fulguration. Follow up period ranged from 3 months to 6 years. At last follow-up, 9 (37.5%) boys had renal failure; 7 patients (29%) had normal renal parameters with good urinary stream. Mortality was 7 (29%) including 3 who died before fulguration. Conclusion: Prenatally detected PUV children seem to have both morphologically and functionally compromised urinary system with poor outcome.

Journal of Paediatric Surgeons of Bangladesh, 2015

Traumatic rupture of the diaphragm is rarely observed in children with thoracoabdominal trauma. A... more Traumatic rupture of the diaphragm is rarely observed in children with thoracoabdominal trauma. Although dyspnea is the commonest symptom, early diagnosis is difficult as chest radiography can diagnose only half of the cases. Prompt diagnosis and surgical repair is life saving. Patient may suffer from multiple associated injuries which is often fatal. A 8 years old boy was admitted with severe respiratory distress and restlessness follwing a history of landslide few hours back. He was pale, cyanosed with hypotension, tachycardia and sweating. Bruise noted over left upper abdomen and left lower chest wall. Surgical emphysema and restricted movement during respiration was noted in the left chest wall with absent breath sound. Abdomen was scaphoid having normal bowel sound. Resuscitation was started and insertion of left intercostal chest drain tube had failed to relieve respiratory distress. A portable chest radiograph showed the chest drain tube in abdomen with mediastinal shifting to opposite side and collapsed lung margin. Left dome of the diaphragm was not clearly visualized. Re institution of chest tube was planned for immediate relief and on withdrawal of the previous drain tube dragged the omentum with it. Then the diagnosis of diaphragmatic rupture was obvious. Laparotomy showed extensive tear of left hemidiaphragm with herniation of abdominal contents. Left costal margin was also torn but abdominal viscera were found intact. Repair was done with interrupted unabsorbable suture after keeping a chest drain tube. Post operatively the patient was kept in ward with adequate analgesia. Check X-ray on 1 st post operative day, showed well expanded left lung. The patient had recovered well. Drain was removed on 3 rd postoperative day and was discharged on 7 th post operative day. High index of suspicion is needed for correct diagnosis. Outcome is satisfactory if treated in time without any associated injury.

Journal of Paediatric Surgeons of Bangladesh, 2015

Background: At the time of diagnosis most of the pancreatic caner is well advanced and curative r... more Background: At the time of diagnosis most of the pancreatic caner is well advanced and curative resection becomes impossible. These are labeled as unresectable carcinoma pancreas where only palliative medical or surgical measures could be done. Objectives: To observe the various types of palliations with their early result. Methods: This retrospective study was carried out in the department of Hepato-Biliary-Pancreatic Surgery in BIRDEM hospital, Dhaka, Bangladesh from July 2004 to June 2006. After careful check 50 patients were labeled as unresectable carcinoma pancreas. Surgical intervention was thought impossible in 10 patients and these patients took only chemotherapy. Laparotomy was carried out in the rest 40 patients with the plan to take open biopsy along with surgical palliation. Curative resection was seemed not to be possible in any patient. After abdominal exploration resectability of the pancreatic lesion was assessed and compared with prior plan. Post operative histopathology revealed pancreatic carcinoma in 35 patients. Postoperative treatment modalities used like chemotherapy, chemoradiation were assessed. Overall outcome of all the palliations were noted and compared with initial presentations. Result: Among 50 patients male were 28 (n 1) & female were 22 (n 2) with male female ratio was 1.27:1. Eighty percent (80%) patients presented between 51 to 70 years of age. Preoperative plan of surgical palliation noted to be changed significantly after laparotomy. Curative resections were possible in 2 patients. No palliative surgery was possible in 2 patients with gross disease and only biopsy was taken. Palliative surgeries along with biopsy were done in 36 patients. Only biliary bypass carried out in 04 patients, choledochojejunostomy with gastrojejunostomy were performed in 18 patients and hepatico-jejunostomy with gastrojejunostomy were performed in 12 patients. Only gastrojejunostomy were carried out in 02 patients to relieve duodenal obstruction. For pain control chemical splanchnicectomy done in 07 patients.There was no perioperative mortality. Early post operative complications were wound infection in 6 (15%) patients, haemorrhage in 2 (5%) patients and bilioenteric anastomotic leakage in 1(2.5%) patient. Post operative histopathology reports revealed pancreatic carcinoma in 35 patients. After one year follow up it was noted that jaundice again developed in 02 patients (4.6%) underwent choledochojejunostomy and gastrojejunostomy. Control of pain was satisfactory in 31 patients (72.1%) by multimodal analgesia. Chemical splanchnicectomy was satisfactory in 4 (56%) patients to control pain. Twenty seven patients (54%) had died within a year. Only 16 (36%) patients were alive after one year. Seven patients (14%) had lost from follow up. Conclusion: Surgical palliation along with other medical palliations is recommended for unresectable carcinoma pancreas.

Journal of postgraduate medicine

We present a case of urinary tuberculosis investigated initially by ultrasound and multidetector ... more We present a case of urinary tuberculosis investigated initially by ultrasound and multidetector computed tomography (MDCT). The MDCT-derived volumetric data were used to generate virtual cystoscopy (VC) images, which revealed a bladder ulcer. The presence of this ulcer was confirmed by conventional cystoscopy-guided biopsy and there was good agreement regarding various features of the ulcer, such as the site, size and shape, as detected by virtual and conventional cystoscopies. VC, a result of simple postprocessing of preacquired MDCT data, proved valuable in the characterization of the bladder lesion in conjunction with CT and ultrasound images. Although a larger study is warranted, in our case these en face VC representations of the ulcer served as useful precursors to conventional cystoscopic biopsy.

Journal of Paediatric Surgeons of Bangladesh, 2013

Fetus-in-fetu is a rare abnormality secondary to the abnormal embryogenesis in a diamniotic, mono... more Fetus-in-fetu is a rare abnormality secondary to the abnormal embryogenesis in a diamniotic, monochorionic pregnancy. It is a rare pathological condition and fewer than 200 cases have been reported in the literature. We are reporting a case in which a 15 year old girl presented with a painful lump in left upper abdomen. Preoperative imaging, exploration and macroscopic examination of the excised specimen revealed it a case of fetus-infetu. This case is unique in terms of age of presentation and mature fetus like external appearance.

Chattagram Maa-O-Shishu Hospital Medical College Journal, 2012

Background: At the time of diagnosis most of pancreatic cancer is in the advanced stage and curat... more Background: At the time of diagnosis most of pancreatic cancer is in the advanced stage and curative resection becomes impossible. These inoperable diseases are labeled as "uresectable carcinonma pancreas. " Accurate and early assessment is essential for such patients to gain a better outcome. Objective: This study was carried out to evaluate clinical presentations, laboratory investigations, histopathology and imaging modalities used to diagnose and label pancreatic carcinoma as unresectable. Methods: This retrospective study was carried out from July 2004 to June 2006 in BIRDEM Hospital, Dhaka. After careful scrutiny of clinical presentation, laboratory imaging studies, tissue diagnosis, tumor markers and operative findings it was seen that 50 patients (sample size n = 50) were labeled as unresectable carcinoma pancreas. Male patients were 28 (n 1 = 28) and female patients were 22 (n 2 = 22). Chi-square (χ 2) test was applied and P value <0.01 was considered as significant. Result: Most (72%) of the unresectable carcinoma pancreas patients presented with weight loss and obstructive jaundice. Laboratory study and ultrasonography (USG) were carried out in all patients (n = 50). Computerized tomography (CT) scan was done in 45 patients, magnetic resonance imaging (MRI) in 8 patients, endoscopic retrograde cholangiopancreatography (ERCP) in 20 patients and upper gastrointestinal (UGI) contrast was carried out in 10 patients. Preoperative biopsy was taken from 25 patients. Most of the patients presented with abnormal liver functions and raised tumor markers. Three patients had mild renal impairment. USG was able to diagnose 84% patients with pancreatic carcinoma and could delineate features of unresectibility in 69% patients. CT scan diagnosed 90% patients with pancreatic carcinoma and outlined the features of unresectibility in 84.44% patients. ERCP was able to diagnose 13 (65%) patients as carcinoma pancreas but failed to delineate the features of unresectibility in any of the patients. UGI contrast was able to diagnose only 10% unresectable pancreatic carcinoma. MRI was 100% accurate in delineating unresectable carcinoma pancreas. Preoperative tissue diagnosis was 88% sensitive in diagnosing pancreatic carcinoma. Conclusion: Presentation of unresectable carcinoma pancreas was obvious in most cases. Laboratory studies were of great help. Multimodal preoperative imagings were 87.5% accurate in diagnosing unresectable carcinoma pancreas. Tissue diagnosis was important as all the lesions were not pancreatic cancer.

Asian Journal of Pediatric Research, Oct 3, 2020

Aims: While the developed world has significantly reduced mortality from surgical conditions in c... more Aims: While the developed world has significantly reduced mortality from surgical conditions in children, there is lack of adequate data on the outcome of children's surgical conditions in the developing world. This study aims at assessing the spectrum of mortalities from children's surgical conditions in a low-middle income country (LMIC). Methods: Mortality data were collected for a period of 12 years (2008 to 2019) among 0 to12-year old children to analyse the diseases which had higher mortality trends, age-group specific mortality trends and categorize those according to body system. Results: Among a total of 30,301 admitted children, 1228 (4.05%) patients died. Among them 53.01% were neonates, 20.28% were infants and 26.71% were children. Male to female ratio was 1.95:1. Mortality from neonatal surgical conditions was 24.21%. Infant mortality rate was 5.65%

Journal of Paediatric Surgeons of Bangladesh, Jul 16, 2014

Spontaneous bile duct perforation (SBDP) is a relatively rare condition. The cause of SBDP is sti... more Spontaneous bile duct perforation (SBDP) is a relatively rare condition. The cause of SBDP is still speculative. Presentation , site of the perforation and management varies. Pancreatic lithiasis (PL) is a very rare entity in childhood. Biliary perforation on the background of PL is still a rare event. This is a case report of 10 years old girl presented as acute abdomen with theclinical diagnosis of acute on chronic pancreatitis, for which conservative treatment followed by laparotomy was carried out.Common bile duct (CBD) perforation was found near it's junction with cystic duct. T tube was instituted and a drain was kept in situ. Postoperative period (POP)was uneventful. T-Tube Cholangiogram was carried out on 12 th postoperative day(POD) that showed dye had passed to duodenum easily and patency and caliber of the CBD was found normal. Multiple stones were noted in the vicinity. No apparent cause of CBD perforation was found. After one month, in follow up visit the patient was found alright. She was asked to come after 3 months for further evaluation. The plan is to evaluate the patient's conditions clinically and biochemically and to do an MRCP to see details of pancreatic pathology. As SBDP in children with PL is a rare condition, high index of suspicion is needed for early diagnosis and proper management of such patient.

Journal of Chittagong Medical College Teachers' Association, Aug 20, 2017

Background: The postoperative complications of urethroplasty in hypospadias surgery still remain ... more Background: The postoperative complications of urethroplasty in hypospadias surgery still remain a great challenge to Paediatric urologists. The aim of the study was to find out the cause and incidence of meatal stenosis and stricture urethra following urethroplasty and to solve the postoperative complication. Materials and methods : This Prospective study was carried out in the department of Paediatric Surgery, Chittagong Medical College Hospital from April 2013 to October 2014 for a total of 19 months. A total of 50 hypospadias patients were selected for this study. After urethroplasty, outcome was assessed in terms of meatal stenosis and stricture urethra in the study period. Results : Meatal stenosis occurred in 5 patients in first follow up, which responded to regular dilatation in 3 patients in second follow up and till the end of third follow up, 2 patients were continuing regular meatal dilatation. In this study, urethral stricture occurred in 2 patient (4%) in second follow up, which was treated with regular urethral dilatation under general anaesthesia. Conclusion : It is evident from this study that, meatal stenosis is not very uncommon after urethroplasty which can very easily be treated by regular meatal dilatation. Urethral stricture, though not common, can also be treated by regular urethral dilatation under General Anaesthesia (GA).

Journal of Chittagong Medical College Teachers' Association, Nov 2, 2014

Journal of Chittagong Medical College Teachers' Association, 1970

Chattagram Maa-O-Shishu Hospital Medical College Journal, Oct 28, 2013

Background: Carcinoma pancreas is being diagnosed increasingly with the help of conventional imag... more Background: Carcinoma pancreas is being diagnosed increasingly with the help of conventional imaging like ultrasonography (USG), computerized tomography (CT) scan and magnetic resonance imaging (MRI).Imaging also gives the opportunity to assess resectability. In our country MRI and CT scan are not widely available and most of the pancreatic carcinoma is too advanced for curative surgical resection when diagnosed. These are unresectable carcinoma pancreas (UCP). Objectives: To evaluate the efficacy of imaging in diagnosing carcinoma pancreas and to assess resectability after comparing them with peroperative findings. Methods: This retrospective study was carried out in the department of Hepato-Biliary-Pancreatic Surgery in Bangladesh Institute for Research and Rehabilitation in Diabetic Endocrine and Metabolic disorders (BIRDEM) hospital, Dhaka, Bangladesh from July 2004 to June 2006 (2 years). After laparotomy findings and histopathological confirmation 50 patients were labeled as UCP. Among 50 patients male were 28 & female patients were 22. Imaging modalities used before surgery was assessed and compared with per operative findings. USG were done in all patients and CTscan in 45 patients. MRI was done in 08 patients suspected clinically as pancreatic carcinoma where USG /CT scan had failed to reach a conclusion. Findings of the various imaging studies regarding diagnosis and unresectability were compared with per operative findings. Results: USG was able to diagnose 42 (84%) pancreatic carcinoma patients with unresectibility in 29 (69%). Forty five patients (90%) were diagnosed by CT scan and could label 38 (84.44%) as unresectable. MRI was 100% accurate to diagnose and label the entire 08 patient as unresectable carcinoma pancreas. Cumulative multimodal preoperative imaging was 91.33% accurate in diagnosing carcinoma pancreas and could tell the features of unresectibility in 73.59% patients. Conclusion: CT scan should be the primary imaging modality for diagnosing pancreatic carcinoma and its resectability. MRI is very promising for diagnosing and assessing UCP. Multimodal imaging is better than single imaging.

Journal of Chittagong Medical College Teachers' Association

Intussusception is a common cause of intestinal obstruction in young children and is a common eme... more Intussusception is a common cause of intestinal obstruction in young children and is a common emergency in infants and children. Hydrostatic reduction of intussusception is a less invasive procedure for both diagnosis and treatment of it. We describe our experience with hydrostatic reduction of intussusception. A retrospective review of the patients of Intussusception admitted in the department of Pediatric Surgery Chittagong Medical College Hospital (CMCH) Chittagong, Bangladesh from January 2009 to December 2013 was done. Patients underwent hydrostatic reduction were evaluated separately. Data were analyzed with regard to success and failure of hydrostatic reduction, necessitating laparotomy, complication and mortality. There were 231 patients of Intussusception. Age range was lmonth to 15 years with median age of 8 months. Male to Female ratio was 2.9:1. Mean duration of presentation was 40 hours after onset of symptoms. Hydrostatic reduction was attempted in 142 patients and was...

Journal of Chittagong Medical College Teachers' Association

Intussusception is a common gastrointestinal emergency in children and appears to have a somewhat... more Intussusception is a common gastrointestinal emergency in children and appears to have a somewhat different clinical spectrum in developing countries. Its etiology is still unclear, but a link to infective agents and viruses has been highlighted. This study aimed to assess the gender and seasonal variation and the disease load of intussusception in Chittagong Medical College and Hospital (CMCH). A retrospective review of the patients of Intussusception admitted in the department of Pediatric Surgery, CMCH, Chittagong; Bangladesh from January 2009 to December 2013 was done. Help was also taken from yearly departmental audits of 2009 to 2013. Data were analyzed with regard to occurrence, seasonal variation, gender variation, diagnosis, treatment and mortality. Statistical analysis was performed by the chi-square test, and mean and percentage values were calculated. P<0.05 was considered to be statistically significant. There were 231 patients of Intussusception. Age range was 1mont...

Journal of Chittagong Medical College Teachers' Association

Midgut volvulus with gangrene is not a rare event. With normal rotation, the mesentery is broad a... more Midgut volvulus with gangrene is not a rare event. With normal rotation, the mesentery is broad and fixed, but the narrow pedicle formed by the base of the mesentery in malrotation of the gut predisposes the midgut to clockwise twisting from the duodenum to the transverse colon. Excessive length of the mesentery, or a point of adhesion at the convexity of the loop may act as an axis for the loop .The actual inciting mechanism is unknown but various possibilities, including unusual movement of the torso, abnormal intestinal peristalsis, or segmental bowel distention, have been suggested. This is a grave surgical emergency to save the life of the patient. We are reporting a case of midgut volvulus with herniation of the ileum into the right paraduodenal recess after blunt abdominal trauma (BAT). A 8 years old boy complaints of abdominal pain, vomiting, and distension of the abdomen following diving to a pond. Abdominal x-ray and USG, CBC, Serum Electrolyte were carried out to evaluate...

Journal of Chittagong Medical College Teachers' Association

Infantile hypertrophic pyloric stenosis (IHPS) is the most common cause of gastric outlet obstruc... more Infantile hypertrophic pyloric stenosis (IHPS) is the most common cause of gastric outlet obstruction in infants with a prevalence of 1.5 to 4.0 per 1000 live births. It has been suggested that the incidence is increasing. USG is the most useful method for diagnosis supplanting physical examination and pyloromyotomy is the time honored treatment option. A retrospective review of the patients of IHPS admitted in the department of Pediatric Surgery, Chittagong Medical College Hospital (CMCH) Chittagong, Bangladesh from January 2008 to December 2012 was done. Help was also taken from yearly departmental audits of 2008 to 2012. Data were analyzed with regard to occurrence, seasonal variation, gender variation, presentation, diagnosis, treatment and outcome. Statistical analysis was performed by the chi-square test, and mean and percentage values were calculated. P<0.05 was considered to be statistically significant. There were 42 patients of IHPS. Age range was 5 days to 1 year 8 mon...

Journal of Chittagong Medical College Teachers' Association, 2011

Introduction : Malrotation is a common anomaly in the pediatric age group which includes a wide ... more Introduction : Malrotation is a common anomaly in the pediatric age group which includes a wide spectrum of anomalies of Rotation. Both acute and chronic presentations are common. Atypical malrotation not having all the features of classic mal Rotation is frequently found which a diagnostic dilemma and the management varies from centre to centre. Materials and Methods : The medical records of all patients with symptomatic malrotation, who underwent surgery between July 2001 to June 2011, were retrospectively reviewed. Patients’ presentation, management, operative findings and complications were evaluated. Results : 68 patients underwent surgery for malrotation at a median age of 2 years. Male to female ratio was 2:1. 28(41%) presented with acute symptoms and 40(59%) with chronic symptoms. 54(79%) patients had vomiting, 36 (%3%) presented with abdominal distension, 19(28%) had recurrent abdominal pain. Diagnostic laparoscopy was done in 7(10%) patients. Ladd’s band was found in 16(2...

Aims: Injuries are becoming major causes of morbidity and mortality throughout the world and onet... more Aims: Injuries are becoming major causes of morbidity and mortality throughout the world and onethird of the injured patients have abdominal injuries. The aim of the study was to analyze epidemiological characteristics of blunt abdominal injuries in children at a tertiary government facility in a lower middle-income country. Study Design: Retrospective chart review study. Place and Duration of Study: Department of Pediatric Surgery, Chattogram Medical College Hospital, between January 2017 and June 2020. Methods: This was a tertiary-level hospital-based study on children admitted with blunt abdominal injuries. Epidemiology, mechanism of injury, other associated injury, organ involvement, treatment and outcome were analyzed. Original Research Article Chowdhury et al.; AJRS, 5(1): 19-30, 2021; Article no.AJRS.65066 20 Results: Among 309 patients, male to female ratio was 3.48:1. Age ranged from 32 days to 12 years (mean 7.29 ± 3.05 7 years). Majority were school-age children (183, 59....

Asian Journal of Medical and Biological Research, 2020

Foreign body (FB) ingestion is common in children worldwide. Type of FB ingestion varies among cu... more Foreign body (FB) ingestion is common in children worldwide. Type of FB ingestion varies among cultures and countries. We retrospectively reviewed all patients of foreign body ingestion who were admitted in Department of Pediatric Surgery, Chittagong Medical College Hospital from January 2017 to December 2019 (total 3 years). Age, Sex, type of foreign body, hospital stay, management and outcome were analyzed. A total of 91 children were admitted with ingestion of FB during this period; male 61, female 30 (male to female ratio 2:1). Age ranged from 3 months to 12 years (median 3.5 ± 3.8 years). Fifty eight percent were less than 5 years old. Children ingested 21 different types of FB; however ingestion of coin was most common (24 patients, 26.37%) followed by different types of pins (19 patients, 20.88%), nail (6 patients, 6.59%), battery (5 patients, 5.49%), screw (5 patients, 5.49%), needle (4 patients, 4.40%), ring (4 patients, 4.40%) and others (18 patients). Sharp object ingesti...

Purpose: To evaluate the outcome of prenatally diagnosed posterior urethral valve (PUV) patients ... more Purpose: To evaluate the outcome of prenatally diagnosed posterior urethral valve (PUV) patients in our setup where fetal interventions are not available. Methods: This prospective study included 24 PUV patients (July 2007 to December 2012), who were diagnosed prenatally but had no prenatal interventions and delivered in our center. Within 24 hours after birth, all of them had urinary ultrasonography (USG). Voiding cystourethrography (VCUG) and renogram were done in the second week and cystoscopy with valve ablation during the same admission period. Patients were followed up regularly after cystoscopic fulguration. Clinical features, treatment, and outcomes were analyzed. Results: Predominant clinical features were renal failure and urinary ascites. Eleven patients (45.8%) had bilateral vesicoureteric reflux (VUR) of different grades. Eight patients (33.3%) had decreased renal cortical thickness (<10 mm). All patients underwent cystoscopic fulguration except three (expired before fulguration). Four patients (16.6%) needed cutaneous vesicostomy along with fulguration. Follow up period ranged from 3 months to 6 years. At last follow-up, 9 (37.5%) boys had renal failure; 7 patients (29%) had normal renal parameters with good urinary stream. Mortality was 7 (29%) including 3 who died before fulguration. Conclusion: Prenatally detected PUV children seem to have both morphologically and functionally compromised urinary system with poor outcome.

Journal of Paediatric Surgeons of Bangladesh, 2015

Traumatic rupture of the diaphragm is rarely observed in children with thoracoabdominal trauma. A... more Traumatic rupture of the diaphragm is rarely observed in children with thoracoabdominal trauma. Although dyspnea is the commonest symptom, early diagnosis is difficult as chest radiography can diagnose only half of the cases. Prompt diagnosis and surgical repair is life saving. Patient may suffer from multiple associated injuries which is often fatal. A 8 years old boy was admitted with severe respiratory distress and restlessness follwing a history of landslide few hours back. He was pale, cyanosed with hypotension, tachycardia and sweating. Bruise noted over left upper abdomen and left lower chest wall. Surgical emphysema and restricted movement during respiration was noted in the left chest wall with absent breath sound. Abdomen was scaphoid having normal bowel sound. Resuscitation was started and insertion of left intercostal chest drain tube had failed to relieve respiratory distress. A portable chest radiograph showed the chest drain tube in abdomen with mediastinal shifting to opposite side and collapsed lung margin. Left dome of the diaphragm was not clearly visualized. Re institution of chest tube was planned for immediate relief and on withdrawal of the previous drain tube dragged the omentum with it. Then the diagnosis of diaphragmatic rupture was obvious. Laparotomy showed extensive tear of left hemidiaphragm with herniation of abdominal contents. Left costal margin was also torn but abdominal viscera were found intact. Repair was done with interrupted unabsorbable suture after keeping a chest drain tube. Post operatively the patient was kept in ward with adequate analgesia. Check X-ray on 1 st post operative day, showed well expanded left lung. The patient had recovered well. Drain was removed on 3 rd postoperative day and was discharged on 7 th post operative day. High index of suspicion is needed for correct diagnosis. Outcome is satisfactory if treated in time without any associated injury.

Journal of Paediatric Surgeons of Bangladesh, 2015

Background: At the time of diagnosis most of the pancreatic caner is well advanced and curative r... more Background: At the time of diagnosis most of the pancreatic caner is well advanced and curative resection becomes impossible. These are labeled as unresectable carcinoma pancreas where only palliative medical or surgical measures could be done. Objectives: To observe the various types of palliations with their early result. Methods: This retrospective study was carried out in the department of Hepato-Biliary-Pancreatic Surgery in BIRDEM hospital, Dhaka, Bangladesh from July 2004 to June 2006. After careful check 50 patients were labeled as unresectable carcinoma pancreas. Surgical intervention was thought impossible in 10 patients and these patients took only chemotherapy. Laparotomy was carried out in the rest 40 patients with the plan to take open biopsy along with surgical palliation. Curative resection was seemed not to be possible in any patient. After abdominal exploration resectability of the pancreatic lesion was assessed and compared with prior plan. Post operative histopathology revealed pancreatic carcinoma in 35 patients. Postoperative treatment modalities used like chemotherapy, chemoradiation were assessed. Overall outcome of all the palliations were noted and compared with initial presentations. Result: Among 50 patients male were 28 (n 1) & female were 22 (n 2) with male female ratio was 1.27:1. Eighty percent (80%) patients presented between 51 to 70 years of age. Preoperative plan of surgical palliation noted to be changed significantly after laparotomy. Curative resections were possible in 2 patients. No palliative surgery was possible in 2 patients with gross disease and only biopsy was taken. Palliative surgeries along with biopsy were done in 36 patients. Only biliary bypass carried out in 04 patients, choledochojejunostomy with gastrojejunostomy were performed in 18 patients and hepatico-jejunostomy with gastrojejunostomy were performed in 12 patients. Only gastrojejunostomy were carried out in 02 patients to relieve duodenal obstruction. For pain control chemical splanchnicectomy done in 07 patients.There was no perioperative mortality. Early post operative complications were wound infection in 6 (15%) patients, haemorrhage in 2 (5%) patients and bilioenteric anastomotic leakage in 1(2.5%) patient. Post operative histopathology reports revealed pancreatic carcinoma in 35 patients. After one year follow up it was noted that jaundice again developed in 02 patients (4.6%) underwent choledochojejunostomy and gastrojejunostomy. Control of pain was satisfactory in 31 patients (72.1%) by multimodal analgesia. Chemical splanchnicectomy was satisfactory in 4 (56%) patients to control pain. Twenty seven patients (54%) had died within a year. Only 16 (36%) patients were alive after one year. Seven patients (14%) had lost from follow up. Conclusion: Surgical palliation along with other medical palliations is recommended for unresectable carcinoma pancreas.

Journal of postgraduate medicine

We present a case of urinary tuberculosis investigated initially by ultrasound and multidetector ... more We present a case of urinary tuberculosis investigated initially by ultrasound and multidetector computed tomography (MDCT). The MDCT-derived volumetric data were used to generate virtual cystoscopy (VC) images, which revealed a bladder ulcer. The presence of this ulcer was confirmed by conventional cystoscopy-guided biopsy and there was good agreement regarding various features of the ulcer, such as the site, size and shape, as detected by virtual and conventional cystoscopies. VC, a result of simple postprocessing of preacquired MDCT data, proved valuable in the characterization of the bladder lesion in conjunction with CT and ultrasound images. Although a larger study is warranted, in our case these en face VC representations of the ulcer served as useful precursors to conventional cystoscopic biopsy.

Journal of Paediatric Surgeons of Bangladesh, 2013

Fetus-in-fetu is a rare abnormality secondary to the abnormal embryogenesis in a diamniotic, mono... more Fetus-in-fetu is a rare abnormality secondary to the abnormal embryogenesis in a diamniotic, monochorionic pregnancy. It is a rare pathological condition and fewer than 200 cases have been reported in the literature. We are reporting a case in which a 15 year old girl presented with a painful lump in left upper abdomen. Preoperative imaging, exploration and macroscopic examination of the excised specimen revealed it a case of fetus-infetu. This case is unique in terms of age of presentation and mature fetus like external appearance.

Chattagram Maa-O-Shishu Hospital Medical College Journal, 2012

Background: At the time of diagnosis most of pancreatic cancer is in the advanced stage and curat... more Background: At the time of diagnosis most of pancreatic cancer is in the advanced stage and curative resection becomes impossible. These inoperable diseases are labeled as "uresectable carcinonma pancreas. " Accurate and early assessment is essential for such patients to gain a better outcome. Objective: This study was carried out to evaluate clinical presentations, laboratory investigations, histopathology and imaging modalities used to diagnose and label pancreatic carcinoma as unresectable. Methods: This retrospective study was carried out from July 2004 to June 2006 in BIRDEM Hospital, Dhaka. After careful scrutiny of clinical presentation, laboratory imaging studies, tissue diagnosis, tumor markers and operative findings it was seen that 50 patients (sample size n = 50) were labeled as unresectable carcinoma pancreas. Male patients were 28 (n 1 = 28) and female patients were 22 (n 2 = 22). Chi-square (χ 2) test was applied and P value <0.01 was considered as significant. Result: Most (72%) of the unresectable carcinoma pancreas patients presented with weight loss and obstructive jaundice. Laboratory study and ultrasonography (USG) were carried out in all patients (n = 50). Computerized tomography (CT) scan was done in 45 patients, magnetic resonance imaging (MRI) in 8 patients, endoscopic retrograde cholangiopancreatography (ERCP) in 20 patients and upper gastrointestinal (UGI) contrast was carried out in 10 patients. Preoperative biopsy was taken from 25 patients. Most of the patients presented with abnormal liver functions and raised tumor markers. Three patients had mild renal impairment. USG was able to diagnose 84% patients with pancreatic carcinoma and could delineate features of unresectibility in 69% patients. CT scan diagnosed 90% patients with pancreatic carcinoma and outlined the features of unresectibility in 84.44% patients. ERCP was able to diagnose 13 (65%) patients as carcinoma pancreas but failed to delineate the features of unresectibility in any of the patients. UGI contrast was able to diagnose only 10% unresectable pancreatic carcinoma. MRI was 100% accurate in delineating unresectable carcinoma pancreas. Preoperative tissue diagnosis was 88% sensitive in diagnosing pancreatic carcinoma. Conclusion: Presentation of unresectable carcinoma pancreas was obvious in most cases. Laboratory studies were of great help. Multimodal preoperative imagings were 87.5% accurate in diagnosing unresectable carcinoma pancreas. Tissue diagnosis was important as all the lesions were not pancreatic cancer.