The painful total hip arthroplasty requires careful evaluation and investigation. This is usually focused on the prosthesis and adjacent anatomical structures. We present a case report of a 64-year-old man who had a Birmingham hip resurfacing procedure for primary osteoarthritis. His hip pain worsened following the procedure and was under systematic investigation for this. Subsequent investigation for vascular disease revealed a total infrarenal aortic occlusion. An aortobifemoral bypass improved the hip pain and function dramatically, and the patient now has an excellent quality of life.

A controlled clinical trial was conducted in the department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh to compare the side-effects of adapalene and benzoyl peroxide combination gel with adapalene monotherapy and benzoyl peroxide monotherapy in the treatment of acne vulgaris. The study conducted in sixty patients. Group A (case) 20 patients were treated with adapalene and benzoyl peroxide combination gel, group B (control) 20 patients were treated with topical adapalene and group C (control) 20 patients were treated with topical benzoyl peroxide. The side effects experienced by patients of different groups in their first follow up were noticed. In group A -erythema, scaling, dryness, burning and pruritus were present in 45%, 10%, 35%, 40% and 10% of patients and in group B, 35%, 25%, 30%, 35% and 15% respectively. However in group C dryness and pruritus were absent in all the patients and the erythema, scaling and burning were 30%, 25% and 25% respectively. In 5 th follow-up visit, in group A-erythema, scaling, dryness and pruritus were present in 15%, 5%, 15%, and 5% of patients respectively and burning was absent in group A. In group B erythema, scaling, dryness, and pruritus were 15%, 5%, 5% and 5% and burning was absent in group B. However in group C scaling, burning, dryness and pruritus were absent in all the patients. Erythema was present in 10% cases in 5 th follow-up visit. It was evidenced in the present study that the overall adverse effect is slightly higher with the adapalene-benzoyl peroxide combination therapy in relation to the adapalene and benzoyl peroxide (BPO) monotherapies in the treatment of acne vulgaris.

Background: Despite the advances made in asepsis, antimicrobial drugs, sterilization and operative techniques, surgical site infection (SSI) continues to be a major problem in all branches of surgery in the hospitals. However, there is no infection control policy that runs effectively in our country. Aim:This study was designed to see the correlation among sterilization, antibiotic resistance and malnutrition with surgical site infection in a tertiary level hospital. Methods: This cross-sectional observational study was conducted in the Department of Surgery, Shaheed Suhrawardy Medical College and Hospital. Informed written consent, detailed history, physical examination and necessary investigations were performed. Total 160 admitted patients undergoing different surgical procedure were included in this study, irrespective of their age, sex, race and ethnic group. Data were collected by using a semi-structured questionnaire. Collected data were analyzed by the SPSS 25. Results: Average age of all patient was 36.10±12.15 years (range: 13-65 years), wherein maximum patients were aged <40 years, male gender (56.3%), had normal BMI (61.3%) and non-smoker (62.07%). About 1/4th patients had diabetes mellitus. Maximum patients had undergone abdominal surgery (34.4%) followed by orthopaedic and traumatology (20.6%),General surgery other than abdominal surgery (18.8%), Neurosurgery (13.8%), Vascular surgery (12.5%). Pre-operative waiting period for surgery was <3 days in most of the cases (48.8%), followed by 3-7 days (31.3%) and >7 days (20%). Mean operation duration was 1.49±0.73 hours. Twenty-nine patients (18%) developed SSI, of which 7% had deep incisional SSI, 6% had superficial incisional SSI and 5% had organ/space SSI. SSI culture reports showed that majority (93.1%) had positive culture growth, wherein 66.7% had single microorganism and rest 33.3% had multiple growth. Staphylococcus aureus (34.48%) was the most frequently found microorganism. surgical team sterility was properly maintained in maximum surgical procedures (71.9%). Besides, OT room and surgical instruments were also properly sterilized in most of the cases (65.6% and 70%, respectively). Older age, abnormal BMI, smoking history, DM, longer pre-operative waiting period and operation duration was significantly associated with development of SSI. Besides, surgical team sterility, OT room sterility and Instrument sterility were not properly maintained in most of the surgical procedures among SSI patients (65.52%, 68.97% and 58.62%, respectively). Conclusion: Abnormal BMI (underweight and overweight or obese) and poor sterilization had significant association with development of SSI. However, further studies are needed to establish and use the findings. J Shaheed Suhrawardy Med Coll 2021; 13(2): 143-149

Enteric fever remains a serious problem in developing countries. School aged children and young adults are mainly the sufferer. Salmonella typhi infection results in a clinical syndrome that varies widely in presentation; especially in new antibiotic era. Records of 52 enteric fever cases who were admitted to BSMMU, from July 2007 to June 2008 was reviewed and information was recorded in a prescribed form. Descriptive analysis was done through SPSS. Mean age was 6.7±4 years and male: female ratio was 1.2: 1. Most common presenting features were fever in 100% cases, abdominal pain 40% cases, vomiting 35% and diarrhea, constipation 10%cases. Hepatomegaly was present in 71% and splenomegaly in 52% cases. In our study32% of children were under 5 years; and the result is similar with some other studies. Typhoid fever is still a disease which is difficult to diagnose. In some cases of delayed response antibiotic may be required for longer duration where patients became afebrile after 10 days or more from starting antibiotic. DOI: http://dx.doi.org/10.3329/bjmed.v21i2.13614 Bangladesh J Medicine 2010; 21: 71-73

Background: In the treatment arena of oncology, there has been growing interests in developing the clinical prediction tools to estimate the risk and severity of patients with breast cancer having axillary nodal metastases. Clinical examination and ultrasonography (USG) for the assessment of axillary lymph node status in breast cancer patients is a traditional diagnostic method in detecting breast cancer and its status. But we have very limited research-based data regarding the effectiveness of clinical examination and USG for the assessment of axillary lymph node status in breast cancer patients. Aim of the study: The aim of this study was to assess the reliability of clinical examination and ultrasonography for the assessment of axillary lymph node status in breast cancer patients. Methods: This was a prospective observational study conducted in the Department Surgery & Oncology, Dhaka Medical College Hospital, BSMMU & NICRH Dhaka, Bangladesh during the period from January 2014 to December 2015. In total 100 patients of several age groups with breast cancer patients attended, diagnosed and treated in the mentioned hospital were selected as the study population. Proper clinical examination and ultrasonography for the assessment of axillary lymph node status were done for every participant. All data were processed, analyzed by MS Office and SPSS program as per need. Results: According to the validity test, the sensitivity, specificity, positive predictive value, negative predictive value, accuracy and likelihood ratio (LR) of the clinical examination in assessment of auxiliary lymph node status in breast cancer patients were 53.7%, 85.0%, 93.5%, 31.5%, 60.0% and 3.58% respectively. As per the validity test, the sensitivity, specificity, positive predictive value, negative predictive value, accuracy and likelihood ratio (LR) of the USG in assessment of auxiliary lymph node status in breast cancer patients were 73.8%, 85.0%, 95.2%, 44.7%, 76.0% and 4.91 respectively.