Introduction: Treatment of Hydrocephalus by placement of Ventriculo-peritoneal (V-P) Shunt is a common neurosurgical practice. But presence of shunt predisposes to increased infection. Objective: To focus on aetiological factors for developing shunt infection. Methods: This prospective observational study was carried out at Neurosurgery Center, Combined Military Hospital, Dhaka during the period of June 2015 to May 2018. A total of 33 patients were included in the study, all of them underwent CSF shunt surgery at this centre. They were followed up for one month after surgery. Age, sex and socioeconomic condition of the patients, types (obstructive or communicating) of hydrocephalus (HCP), aetiology of HCP, duration of surgery, shunt type used and routine or emergency surgery were the factors that were analysed for possible association with infection. Results: Eight (24.2%) patients developed shunt infection, among whom infants and male were predominate. Low socio-economic group, prolonged operation time and emergency surgery were found to have association with increased rate of infection. Conclusion: V-P shunt insertions had unacceptably high infection rate despite the presence of a protocol for the procedure. A protocol should be developed for strict compliance and where possible, alternative procedure Endoscopic Third Ventricullostomy (ETV) or External Ventricular Drain (EVD) should be employed to minimize shunt infection. JAFMC Bangladesh. Vol 18, No 1 (June) 2022: 16-18

Background: Spinal instrumentation provides a stable, rigid column that encourages bones to fuse after spinal fusion surgery. Methods: The study was carried out in the Neurosurgery Center, CMH, Dhaka, from 01 January 2013 to July 31 2018. A total of 95 patients were included with unrestricted age and gender, underwent spinal surgery with fixation. Result: Better outcome was observed in spinal surgery with stabilization. Conclusion: Whereas early (within hours) or immediate (within 48 h) stabilization and indirect or direct decompression has excellent outcome, even delayed stabilization of the unstable spine has benefits. Bang. J Neurosurgery 2019; 9(1): 11-15

Introduction:The endoscopic endonasal approach is a minimally invasive surgical technique for removal of skull base lesions by using nose and sinuses as natural corridors. This study represents our institutional experience with endoscopic endonasal trans-sphenoidal approach for anterior skull base lesions. Objective: To find out surgical outcomes of endoscopic endonasal trans-sphenoidal approach for treatment of anterior skull base lesions. Materials and Methods: Cross-sectional observational study of 38 consecutive patients who underwent endoscopic endonasal trans-sphenoidal surgery for anterior skull base lesions in Combined Military Hospital, Dhaka from July 2013 to June 2017. Results:This study included 16 men and 22 women, ranging from 24 to 68 years of age where median was 38 years. Common presentations were visual disorder (60%), headache (30%), features of pituitary apoplexy (5%), Cushing disease (0.35%), acromegaly (0.7 %), galactorrhoea (0.35%). Radiological evaluation revealed intrasellar (12), sellar and suprasellar (22), sellar and parasellar (1), tuberculum sella and planum sphenoidale (3), clival (1) lesions. Recurrent cases (3/38) were nonfunctioning pituitary macroadenoma, prolactinoma, and growth hormone secreting macroadenoma. The surgical resection in relation to post op imaging were 45% as gross total resection, near-total in 35%, subtotal in 15%, and partial in 5%. We found fifteen patients experienced improvement in visual acuity, while one patient worsened. Common complications were transient diabetes insipidus (53%), new pituitary deficit (35%), endonasal adhesions (20%), and cerebrospinal fluid leak (5%). Surgical mortality was (0.35%). The histological diagnoses included twenty-eight pituitary adenomas, five craniopharyngioma, three meningioma, one Rathke’s cleft cyst and one clival chordoma. Conclusion: Endoscopic endonasal transsphenoidal surgery is a valuable treatment option for an anterior skull base lesion. Journal of Armed Forces Medical College Bangladesh Vol.14(1) 2018: 66-68