Endometriosis affecting the skin is a very much rare surgical entity encountered almost exclusively in women of childbearing age. It commonly presents as a discoloring painful cutaneous swelling, the pain being most commonly a cyclical one occurring during menstrual bleeding. It often needs histopathological examination to arrive at a correct diagnosis. Otherwise, the diagnosis is usually presumptive from typical and atypical presentations and other supportive imaging investigations. Wide surgical excision is the gold standard curative treatment of choice. Nonsurgical treatment includes use of such hormonal agents as danazol or leuprolide, oral contraceptive pills, etc. which can’t definitely cure the patient from this nonfatal ailing disease. All other examples of benign and malignant cutaneous swellings like desmoid tumors, fibro-histiocytoma, dermatofibroma protuberans, papilloma, melanoma, visceral malignancies and many other types of fibromatosis are to be included in the differential diagnosis. These patients with cutaneous endometriosis need to be additionally evaluated for endometriosis elsewhere in the body especially in the pelvis and the abdomen proper, though no other tissue like brain, lungs, liver etc. are not immune to it. In women of childbearing age with abdominal or pelvic wall masses or an area of soft-tissue thickening at cross-sectional imaging in or very close to previous surgical scars, endometriosis is to be strongly suspected by the consulting radiologist. Imaging investigations like CT, USG, and especially, MRI may help in the diagnosis of scar endometriosis, but it is only the biopsy that is definitely confirmatory. KYAMC Journal. 2022;12(04): 243-249

Appendicitis has its acute, subacute, recurrent and chronic forms. Appendicitis is commonly predisposed to and precipitated by a single or a combination of multiple discrete factors like obstruction of lumen, ischemia from thromboembolic episodes, infection or idiopathic etc. Typically, it starts as umbilical or peri-umbilical or midline abdominal dull aching pain that soon gets localized in the right iliac region. Movements worsen the pain. Other typical features include nausea, vomiting, anorexia, pyrexia, preference to lie down with or without curling up, chills, constipation, diarrhea, fever, shaking etc. The atypical symptoms of appendicitis include a dull or sharp pain anywhere in the abdomen, back, rectum, painful urination, bloating, flatulence, generalized abdominal tenderness, distension simulating acute intestinal obstruction, enlarging abdominal mass with or without overlying skin erythema, normal bowel movements, normal vital signs and even with no pain, no nausea, no vomiting no pyrexia or no weight loss. These atypical symptoms very often misguide the primary care physicians and the surgeons resulting in failure of diagnosis putting the patients to the risks of life-endangering complications. Diagnosis of appendicitis in absence of typical features are to be made from pre-occupied knowledge and clinical suspicion with or without the help of biochemical and/or imaging studies. Early and timely diagnosis and appropriate treatment are essential to save the life and to reduce the morbidity as well. Appendicitis should be thought in all cases of abdominal pain irrespective of its type and location, as must meningitis be thought in all cases of headaches. KYAMC Journal.2021;12(02): 101-106

Background: Urolithiasis is one of the most prevalent urological disorders and the prevalence of urinary stones has increased world wide1. The management of urinary calculi was revolutionized by the introduction of extracorporeal shockwave lithotripsy (ESWL) in 1980 and the first successful ESWL treatment was accomplished in Germany by Dr. Christian Chaussy using a Dornier HM1 lithotripter. ESWL is a safe, effective and non-invasive method2.Purpose: To observe the outcome of pushback stenting and ESWL versus in situ ESWL for upper ureteric stone.Materials and methods: It was a quasi-experimental study. The study was under went in the department of urology, Dhaka Medical College and Hospital, between July'2012 to June'2014. Total 60 patients of single upper ureteric stone who satisfy inclusion and exclusion criteria were enrolled in this study. Selected patients were dived into two groups, group A and group B. Group-A for pushback stenting and ESWL and group-B for in situ ESWL. Results were compared in terms of clearance rates, number of shock waves, sessions, incidence of complications and failure rate.Results: Failure of ESWL was significantly higher in Group B (23.33%) than Group A (10%). These results were statistically significant.Conclusion: Pushback stenting and ESWL is better than in situ ESWL for upper ureteric stone.KYAMC Journal Vol. 8, No.-1, Jul 2017, Page 4-9

Covid-19 had been identified as an acute respiratory disease and many other systemic illnesses, causing unusual morbidity and death, particularly in older people and other people with co-morbidities. The disease is caused by an extremely infectious, super rapidly spreading and super-promptly mutating novel coronavirus, now known as the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2 virus). Covid-19 became a pandemic in 2020 and 2021. Though its pandemic nature is now declining, it is still in existence in many parts of the world, causing substantial mortality and morbidity. The Wuhan Municipal Health Commission of Hubei province, officially notified it first on December 31, 2019, though the first date of symptom onset of a cavid-19 case was first recorded on December 8, 2019 on basis of the patient’s recall during the investigation in the Wuhan city of central China. China publicly had circulated the genetic make-up of the causative virus on January 12, 2020. From the 1st January, 2020 onwards, the WHO (World Health Organization) had worked on it several times at several levels till March 11, 2020, When WHO deeply notified its alarming spread and severity, characterizing it as a pandemic. It had created a severe panic all over the world, interfering with life, health, economy, trade, commerce, livelihood and living standard of people. This Covid-19 had taught us a myriad of lessons how to tackle and handle catastrophic massive disasters in emergent situations, probing into our limitations and requirements and emphasizing on local, regional. national and international awareness, cooperation and coordination.  KYAMC Journal Vol. 13, No. 03, October 2022: 170-176

Idiopathic Granulomatous Mastitis (IGM), or Granulomatous Lobular Mastitis (GLM) or simply GM (Granulomatous Mastitis) is a benign chronic and sometimes recurrent inflammatory process of unknown etiology, involving one or both breasts, commonly in women of childbearing age. In has no definite diagnostic hallmark or marker. It is to be diagnosed by exclusion of all other diseases. Biopsy is mandatory. A challenge is there to differentiate IGM from other diseases including malignancy, tuberculosis and other granulomatous reactions, It has no specific curative treatment. Breastfeeding from the IGM breast is safe, if not on immunosuppressive or steroid treatment. It has long been classically treated with oral steroids with or without such other immunomodulators as methotrexate, azathioprine etc. Recently, intralesional triamcinolone injection has been shown to improve the symptoms. But local high concentration intralesional triamcinolone, systemic immunosuppressive agents are unsafe for breastfed babies. If a woman chooses systemic treatment, after Shared Decision Making (SDM), she should be cautioned about milk suppression and untoward effects both in mother and baby. Some women prefer no medication during lactation. Complicated cases or failure of conservative treatment calls for surgical treatment in the form of local wide resection or mastectomy etc. The patients may suffer physically, mentally, and economically, significantly lowering the quality of life. There is no consensus on its management strategies. Its management still remains as a challenge. We like to review, discuss, and share about its masked etiology, presentations, diagnostic aids plus the available avant-garde optimum management strategies. KYAMC Journal Vol. 13, No. 04, January 2023: 250-256