Search

Background: Parathyroid dysfunction leading to symptomatic hypocalcemia is not uncommon following a total or completion thyroidectomy and is often associated with significant patient morbidity and a prolonged hospital stay. Objectives: To investigate whether postoperative parathyroid hormone level is a parameter to identify hypocalcaemia after total thyroidectomy. Methods: This prospective longitudinal study was carried out with variety of thyroid disorders with indication of total thyroidectomy at BSMMU. Total 103 patient were selected following the inclusion and exclusion criteria. The routine clinical assessment and the preoperative laboratory investigations of the study population were performed before operation. Preoperative and postoperative levels of serum PTH and serum calcium level were measured. Results: Immediate post-operative period 17(16.50%) patients PTH level were low (

Background: Gallstone disease (GD) is one of the most prevalent gastrointestinal disease in worldwide and also in Bangladesh. High triglyceride and low HDL (high density lipoprotein) are associated with cholelithiasis whereas total cholesterol and LDL (low density lipoprotein) have less association. Objectives: To find out the association of cholelithiasis and lipid profile. Material and Methods: This case-control study was conducted on 300 patients in the department of surgery, Rajshahi Medical College Hospital from September, 2018 to August, 2019. Participants were divided into two groups; group A (case group- 150 patients) and group B (control group-150 patients). After overnight fasting 5 ml venous blood was collected and serum lipid profile was measured. Outcomes were expressed in the form of figures and tables. Result: The mean age in case group were 39.79±8.16 years and in control group 38.67±7.99 years respectively with female predominance (72%) and male to female ratio was 1:2.57. out of 150 participants in case group 61% (91) had cholesterol stone. TG level was high both in cholesterol stone 57 (62.62%) and mixed stone 35 (59.32%) in case group. The mean BMI (25.73±2.10) in case group were significantly higher. Post-operative histopathology shown 2 (1.33%) patients associated with malignancy. Conclusion: The increased lipid profile can be good indicator for gall stone diseases and female are more susceptible to form gallstone who have high cholesterol level. Obesity is a risk factor for gallstone so people should maintain an ideal body weight. Gallstones are predisposing factor for malignancy. Sir Salimullah Med Coll J 2021; 29(2): 95-99

Background: Ileal perforation is a very frequent surgical emergency in surgery wards. In tropical country infection is the commonest cause. Repair of perforation, primary repair with loop ileostomy and resection and primary anastomosis are the commonly performed methods. Objectives: To identify the aetiology and assess the outcome of resection and primary anastomosis in multiple ileal Perforation. Study Procedure: This Quasi experimental study was carried out in the Department of Surgery, Rajshahi Medical College Hospital, Rajshahi. 92 patients were included in this study. Thorough clinical, Radiological and biochemical parameters evaluation with postoperative histopathology were performed. All patients treated with resection and primary anastomosis. Different types of Data and variables were recorded through data collection sheet. Mean and frequency of all quantitative and categorical variables were determined. Results: The mean age 42.60±4.44 (age range:18-69) years. Out of 92 patients 74(80.43%) were male and 18(19.56%) were female and ratio was 4.11:1.Presentation were 92(100%) abdominal pain, vomiting 74(80.43%), fever 60(65.21%) and abdominal distension 56(60.86%). Common Cause were typhoid fever 43(46.73%) and nonspecific inflammation 28(30.43%). Patient suffered from wound infection 18(19.44%), dehiscence 7(7.56%), anastomosis leakage 6(6.68%) and 5(5.43%) patient experienced incisional hernia. 74(80.43%) recovered uneventfully, 17(18.47%) recovered with complication and only 1(1.08%) died. Conclusion: Among the infections, typhoid fever is still the prime cause of multiple ileal perforation. Wound infection, wound gap, burst abdomen & primary repair leakage are the common complications. Uneventful outcome is present in majority cases. Delayed presentation, nutritional status and anastomosis from ileocaecal valve are the important deciding factor of worst outcome. Sir Salimullah Med Coll J 2021; 29(2): 153-157