Assessing only the number of EmONC facilities does not ensure universal coverage; accessibility should be assessed when planning health systems.

Backgraound: Open appendectomy (OA) has been the treatment of choice for acute appendicitis since its introduction by Mc-burney in 1884. Laparoscopic appendectomy(LA) though widely practiced, has not gained universal approval. LA was first described in 1983. Some early studies showed equivocal results about benefit of LA. Recent studies showed overall benefit in favour of LA. So far no such a large study was done in any Bangladeshi hospital. So, we decided to do this study with a view to evaluate the therapeutic benefit of LA by comparing with conventional OA . Materials and methods: We collected data of 763 appendectomies done in Jahurul Islam medical college hospital from July 2007 to June 2012 for a period of 5 years. Out of them 448 had conventional OA and 315 had LA. We compared the mean operation time, time of first oral feeding, narcotic analgesic requirement, duration of post operative hospital stay. Results: We found that mean operation time was 33±5.8 minute and 37± 7.5 minute in LA and OA respectively. Duration of post operative hospital stay was 1.2 days shorter in Laparoscopic group. LA required 1.1 shots of less analgesic than OA. Oral feeding was resumed 21 hours earlier following LA compared to OA. Laparoscpic appendectomy was safely performed in paediatric patient without any adverse effect. We also found that, in female patient, concurrent ovarian cysts, tubal pregnancy and endometriosis can be diagnosed and managed laparoscopically in the same sitting. Conclusion: Our study found that laparoscopic appendectomy is an effective and safe procedure irrespective of age and sex of the patient. LA has added advantage of early return of bowel movement, less post-op hospital stay and less requirement of narcotic analgesic.

To correlate magnitude and distribution of coronary Artery Disease (CAD) with ischaemic limb changes in  patients with Peripheral Arterial Disease (PAD) of lower limbs.Most common cause of PAD is atherosclerosis.  Atherosclerosis is a generalized disease and often atherosclerotic CAD is associated with PAD. Because of  ischaemic limb changes in patient with PAD they do not always experience angina even after having CAD.  This prospective observational study was conducted in National Institute of cardiovascular Diseases (NICVD)  Dhaka, Bangladesh during July 2004 to June 2005. Total 58 patients with PAD were included in the study.  Patients were classified as group I having normal coronary artery, group-II insignificant CAD (L M <50%  stenosis, others <70% stenosis) and group-III significant CAD (LMe” 50% stenosis, others e” 70%, stenosis).  Ischaemic limb changes was significantly higher in patients with CAD compare to non-coronary artery  disease (P = 0.047).This study suggests that ischaemic limb changes had significant relation with the presence  of CAD. DOI: http://dx.doi.org/10.3329/uhj.v8i1.11660 University Heart Journal Vol. 8, No. 1, January 2012

Abstract:Background

A 20 years old man presented with 4 year history of painless swelling of the left testis. He ignored this swelling until he started having pain in the abdomen. Ultrasonography revealed testicular malignancy with multiple para-aortic lymph nodes enlargements in the abdomen. His X-ray chest showed pulmonary metastasis. One tumor marker was raised. Histology revealed mixed germ cell tumour with a rare combination of seminoma and embryonal carcinoma. Because of this rare combination of 2 varieties of testicular germ cell tumor and extensive systemic metastasis we presented this case. We discussed the epidemiology, incidence, classification, staging, treatment and prognosis of testicular cancer.Anwer Khan Modern Medical College Journal Vol. 6, No. 1: January 2015, Pages 50-54