Background: Urinary catheterization is routinely done in major gynaecological and obstetric operations in our country. It has some advantages and disadvantages of its own. Among the advantages, it can significantly prevent retention of urine, help in measuring urinary output, avoid discomfort due to full bladder, prevent postpartum hemorrhage and reduce spinal headache due to reduced movements. On the other hand, it can be a constant source of urethral irritation leading to UTI and can cause urethral strictures. So, a quantitative research is necessary to determine the relationship between urinary catheterization and UTI, for establishing a guideline for judicious catheterization. Methods: Between January 2010 and December 2011, data was collected for conducting an cross-sectional observational study on 49 subjects undergoing various gynaecological and obstetric operations. Precatheterization urine for routine and culture-sensitivity findings were recorded and compared with catheter tip culture and sensitivity after removal. Besides, other factors e.g. clinical history, comorbidity status, hemoglobin status, duration of catheterization, nature of operation etc was brought into consideration. Results: Patients having urinary catheters for more than 5 days, were found to be more than twice as likely to be developing UTI in various operations, than the patients having catheter for one day. Preoperative albuminuria was also found to be a likely predisposing factor, as the percentage of patients with UTI who had preoperative albuminuria was double compared to the preoperative albuminuria negative patients. The direct relationship between nature of operation and development of post-catheterization UTI was difficult to establish, because of the duration of catheterization acting as a confounding variable. Conclusion: In most cases of LUCS and hysterectomy, catheter-associated complications can be overcome by avoiding catheterization altogether. This can be better achieved by encouraging the patient to void their bladder immediately before surgery. In long and complicated operations, catheterization cannot be avoided but the postoperative duration of catheterization can be reduced to avoid complications. Moreover, preoperative optimization of comorbid status, hemoglobin status, albuminuria etc can bring forth a favourable outcome in terms of catheterassociated complications. Bangladesh Journal of Medical Science Vol.18(4) 2019 p.696-702

Introduction: Nipple discharge is the presenting complaint in 3-10% of all women with breast-related complaints. It causes considerable anxiety in the modern cancer-conscious woman. Breast surgeons frequently use various tools for diagnosing the underlying cause of nipple discharge. A definitive diagnostic approach is crucial for an accurate diagnosis of the aetiology and exclusion of any malignant breast lesion. The objective of this study was to evaluate diagnostic performances of ductography and microdochectomy and compare these with other conventional diagnostic tools. Methods: This retrospective study included 153 female patients presenting with significant nipple discharge to “Breast Care Center” from December 2011 to December 2018. Informed consent was taken from all participants. History, clinical examination, relevant imaging, cytology and histology findings of all the patients were recorded in electronic database. Results: Mean and median age of the cohort were 38.4 years and 35 years respectively. 18 of the 153 patients, had a positive family history for breast cancer which was statistically significant. 3.9% (6/153) patients were eventually diagnosed (cytopathology-1, FNAC-1, ductography-1 & microdochectomy-3) with in situ or invasive malignancies while being evaluated for nipple discharge. Breast ultrasound has sensitivity and specificity of 28.6% (5.1-69.7) & 99.3% (95.7-99.9) respectively at 95% CI in detecting risk lesions. Sensitivity of ductography in detecting risk lesions was 100% (95% CI: 5.4-100) with specificity value of 95.2% (95% CI: 85.8-98.8). Again, microdochectomy has been used as final diagnostic as well as therapeutic tools in the study. Conclusion: Ductography is a noninvasive imaging modality whereas microdochectomy, although invasive, helps reach a definitive tissue diagnosis. Ductography and microdochectomy together can serve as indispensable diagnostic tools alongside the conventional radiological and histological tools. J Bangladesh Coll Phys Surg 2022; 40: 263-269

Study on the Thicknesses and the Girths of Tendoachilles of Human Cadavers. Background: Tendoachilles is the chief planter flexor of the ankle joint. It provides elastic energy storage in walking and running. The present study was planned to collect data to find out possible variations of thickness and girth between right and left leg of both male and female. Materials and methods: A cross sectional analytical type of study was conducted in the department of Anatomy, Dhaka Medical College, Dhaka, from July 2013 to June 2014. The data was collected from both right and left tendoachilles of 60 human cadaver taken from Anatomy Department of different Government and Nongovernment Medical Colleges in Dhaka city. After dissection thickness and girth of tendoachilles was measured and recorded. Results: Among 60 human cadaver, 30 are male and 30 are female. The mean thickness of tendoachilles was greater in right leg than in left leg at its junction with gastrocnemius in male, (P<0.001) at the level of 4 cm above its junction with calcaneus and at the level of its junction with calcaneus in both male and female. No significant difference was observed in the measurement of thickness of right and left tendoachilles at the level of its junction with gastrocnemius in female. Mean girth of tendoachilles was greater in right leg than in left leg at its junction with gastrocnemius, at the level of 4 cm above its junction with calcaneus and at the level of its junction with calcaneus in both male and female. Conclusions: The present study revealed that thickness and girth of tendoachilles was greater in right leg than in left leg which were statistically significant. The difference in thickness and girth can be useful during repair of rupture tendon by orthopaedic and plastic surgeon. J Shaheed Suhrawardy Med Coll, December 2019, Vol.11(2); 124-129

Kaposi's sarcoma is a vascular tumor usually involves skin, mucous membrane and other organs. HIV associated Kaposi's sarcoma is very rarely reported in Bangladesh. The reporting case was presented with a recurrent, ulcerated, firm nodule on left groin along with multiple blackish flat or raised lesions on different parts of body. According to previous histopathological report this case CASE REPORTS was operated as a case of recurrent fibrous histiocytoma and this time the diagnosis was confirmed histologically and by immunohistochemistry as Kaposi's sarcoma. Later, it was found that the patient is serologically positive for HIV.

Background: Tendoachilles is the chief plantar flexor of the ankle joint. The present study was conducted to find out the possible variations of tendoachilles between the right and the left leg of both male and female.Materials and methods: A cross sectional observational study was conducted in the department of Anatomy, Dhaka Medical College, Dhaka, from July 2013 to June 2014. The data were collected from both the right and the left tendoachilles of 60 human cadavers taken from Anatomy Departments of different Government and Nongovernment Medical Colleges in Dhaka city. Among the 60 cadavers, 30 were male and 30 were female. After dissection, the length of tendoachilles and the breadths at different levels of tendoachilles were measured and recorded.Results: The mean length of tendoachilles was significantly greater in the right than in the left leg of both male and female. The tendoachilles was longer in male than in female in both the right and the left leg (P<0.01). There was significant positive correlation between the height of cadaver and the length of tendoachilles of both the right leg and the left leg in case of male. Positive correlation was also observed between the height of cadaver and the length of tendoachilles of both the legs in case of female, but that was not statistically significant. The mean breadths of tendoachilles were significantly greater in the right leg than in the left leg at its junction with gastrocnemius and at the level of its junction with calcaneus in both male and female and also in male than in female in both legs. Significant difference was observed between the breadth of right and left tendoachilles at the level of 4 cm above its junction with calcaneus in male but not in female (P>0.05).Conclusion: Significantly greater values were observed in the length and in most of the breadths of tendoachilles in the right leg of both sexes and in male in both legs. There was significant positive correlation between the height of cadaver and the length of tendoachilles of both legs in case of male, but, not in female.Bangladesh Journal of Medical Science Vol.17(3) 2018 p.388-394