Background The association of circulating lipids with breast cancer is being debated. The objective of this study was to examine the relationship between abnormal plasma lipids and breast cancer risk in Bangladeshi women. Methods This was a case-control study designed using a population of 150 women (50 women in each group). The lipid levels of women with breast cancer were compared to the lipid levels of women with benign breast disease (control group 1) and healthy women (control group 2). Study samples were collected from the Department of Surgery, Bangabandhu Sheikh Mujib Medical University, for a period of 1 year. Ethical measures were in compliance with the current Declaration of Helsinki. Statistical analysis was performed with SPSS version 26. Results All of the comparison groups shared similar sociodemographic, anthropometric and obstetric characteristics. The incidence of dyslipidemia was significantly higher in breast cancer patients (96%) than in healthy women (84%) and patients with benign breast disease (82%) (P < 0.05 for both). The levels of total cholesterol, triglycerides, and low-density lipoprotein (LDL) cholesterol among the breast cancer patient group were significantly higher than those among both benign breast disease patients and healthy women (P < 0.05), except for high-density lipoprotein (HDL) cholesterol. Adjusting for other factors, body mass index (BMI) (kg/m2) (> 23) [OR 53.65; 95% CI: 5.70–504.73; P < 0.001] and total cholesterol (mg/dl) (≥ 200) [OR 16.05; 95% CI: 3.13–82.29; P < 0.001] were independently associated with breast cancer. Conclusions Total cholesterol and BMI are independent predictors of breast cancer risk among Bangladeshi women.

Introduction. Circumcision is a common procedure carried out around the world. Due to religious reasons, it is routinely done in Bangladesh, by both traditional as well as medically trained circumcisers. Complications include excessive bleeding, loss of foreskin, infection, and injury to the glans penis. Myiasis complicating male circumcision appears to be very rare. Case Presentation. In 2010, a 10-year-old boy presented to the OPD of Dhaka Medical College Hospital with severe pain in his penile region following circumcision 7-days after. The procedure was carried out by a traditional circumciser using unsterilized instruments and dressing material. After examination, unhealthy granulation tissue was seen and maggots started coming out from the site of infestation, indicating presence of more maggots underneath the skin. An emergency operation was carried out to remove the maggots and reconstruction was carried out at the plastic surgery department. Conclusion. There is scarcity of literature regarding complications following circumcision in developing countries. Most dangerous complications are a result of procedure carried out by traditional circumcisers who are inadequately trained. Incidence of such complications can be prevented by establishing a link between the formal and informal sections of healthcare to improve the safety of the procedure.

Abstract:Objective: The authors present their experiences in the management of extradural haematoma in children which involved an aggressive diagnostic approach, prompt surgical evacuation of the haematoma results in an excellent outcome.

Background: Mirizzi syndrome is a condition, difficult to diagnose pre-operatively and treat, represent a particular challenge for hepatobiliary surgeons. Furthermore, it increases the risk of intra-operative biliary injury, particularly during laparoscopic cholecystectomy. The aims of this study were to point out some particular aspect of diagnosis and treatment of this condition that will be helpful for the surgeons. Methods:We retrospectively reviewed all records of the patients, surgically treated for Mirizzi syndrome from Patients' presentation, diagnostic methods, treatment and complications were recorded.Results: During the study period, a total of 1320 cholecystectomy were performed, out of which 50 patients were diagnosed with Mirizzi syndrome, representing an incidence rate of 3.78%. Male to female ratio was 0.72:1 and mean age was 54.14 years. When we analyzed the main symptoms in the clinical debut, we found that common features were jaundice (31, 62%), cholangitis (20, 40%) and abdominal pain (22, 44%). Roux en Y hepaticojejunostomy was the treatment of choice and subtotal cholecystectomy were done for 7 cases and laparoscopic cholecystectomy for 2 cases. Mean hospital stay was 4.8±2.9 days. There was no post-operative mortality. Two cases of biliary fistula resolved with conservative management and another case required percutaneous treatment for resolution of an intraperitoneal postoperative collection. Conclusion:Mirizzi syndrome continues to be a disease of difficult diagnosis and treatment. General surgeons without long experience in hepatobiliary surgery should refer the patient to a specialized hepatobiliary surgical center. In most of the cases biliary reconstruction is inevitable. It is important for the surgeons to know the disease and possible intra-operative challenging situations.

Background: Liver remains the second most common injured organ in both blunt and penetrating trauma of the abdomen. Management of blunt or penetrating injury to the liver remains a significant challenge to trauma surgeons. Unstable patients require immediate laparotomy. Selective patients can be managed without surgery and with careful monitoring. Mortality is mainly due to damage to major hepatic blood vessels, massive parenchymal and biliary injury. Associated non-hepatic injuries contribute greatly to the overall mortality. With improved understanding of the major causes of mortality from hepatic injury, adequate resuscitation, well planned surgical intervention and better intensive care facilities have decreased mortality and morbidity Objectives: Performed to assess incidence, mechanisms, management and outcome of traumatic liver injury. Methods: This prospective study was performed in Dhaka Medical College Hospital between January 2013 to December 2014. Sixty patients with hepatic injury were included in the study. Data collected in data collection sheet regarding demographic data, severity of liver injury, hemodynamic status on admission, investigations reports, concomitant injuries, management scheme, and outcome of patients which were then analyzed. Results: There were 39 male and 21 female patients with a mean age of 31.3 (SD=15.4) years. Road traffic accident was the most common injury mechanism (71%). 20 patients (33%) were in shock at the time of admission. 48 patients (80%) with liver injury had associated injuries of other organs. Majority of the patients (41%) were found with grade Ill injury. 50 patients (83%) needed surgical interventions. Most common (16%) complication was wound infection. 3 patients (5%) died in this series. 5 patients (8%) developed liver abscess on subsequent follow up. Conclusion: Most of the trauma victims are young and in the active state of life. Prompt resuscitative measures, assessment of extend of hepatic injury and associated injuries, well justified surgical intervention along with critical care support can contribute greatly to the survival of victims of hepatic injury. Journal of Surgical Sciences (2018) Vol. 22 (1): 36-42