Background: As a part of modern surgical procedure, laparoscopic mesh repair of inguinal hernia should be safe, effective and have a short period of convalescence. Objective: This study was designed to compare the outcome following inguinal hernia repair, performed by laparoscopic technique and open mesh Lichtenstein (tension-free) repair. Materials and Methods: This prospective quasi experimental study was carried out in the department of surgery, Bangabandhu Sheikh Mujib Medical University, for a period of twelve (12) months. Total thirty six patients of inguinal hernia were included in this study. Result: Mean (±SD) age was 38.17 (±8.64) years. Mean (±SD) time for unilateral inguinal hernias were 55.30 (±11.01) minute in open mesh repair where as 76.07 (±13.71) minute in laparoscopically. For bilateral inguinal hernia, mean (±SD) time for open mesh repair was 92.4 (±10.26) minute and 81.2 (±10.44) minute in laparoscopically Seroma formation was in 4 patients of open mesh repair where as 5 patients of laparoscopic mesh repair. Sixteen patients of laparoscopic mesh repair needed more anaesthetic narcotics 16 patients of laparoscopic mesh repair had return to work within two weeks of surgery whereas only 10 (55.6%) patients of open mesh repair had return to work during same period of time. Pain at surgical site and discomfort was more in open mesh repair. Conclusion: Laparoscopic mesh repair is better than open mesh repair of inguinal hernia.

Bang Med J Khulna 2013; 46 : 12-15

Introduction: Hearing impairment has a devastating, detrimental, and adverse impact on the development of the newborn. Unfortunately, this hidden disability remains undetected for many newborns until it is too late to prevent undesirable and often irreversible damage. It has long been recognized that undiagnosed hearing loss, even a mild loss at birth, can negatively affect speech and language development, Resulting in poor academic achievement and social-emotional development. According to WHO 2009, newborns in the NICU are 10-20 times at higher risk of developing hearing loss. The risk factors associated with newborn hearing impairment vary from country to country and even within countries. There has been a paucity of studies on this topic from Bangladesh. This study was done to identify the risk factors associated with newborn hearing impairment in the study place.  The objective of the study: To identify risk factors associated with newborn hearing impairment in the study group. Methodology: A prospective observational study was conducted in the department of neonatology, BSMMU. After taking consent from the parents/guardians, a thorough history of these newborns, including particulars of the neonates, family history of hearing loss, treatment history, antenatal, natal, and postnatal history, was recorded in a data collection form. Newborn admitted to the NICU during the study period was the study population. The newborn who meet the inclusion criteria was screened with Transient Evoked Otoacoustic Emissions (TEOAE) close to discharge from the NICU or before one month of age. A second screen was done with TEOAE again after one month of 1st screen but prior to 3 months of postnatal age if referred in 1st screen. Diagnostic Auditory Brain stem Response (ABR) was made to confirm the hearing impairment, and it was done prior to 3 months of postnatal age if referred in both the 1st and 2nd screens. Data were analyzed by statistical package for social sciences (SPSS) version 20. Results: 426 valid recordings from 493 newborns admitted in the NICU enrolled consecutively constitute the basis of this study. 14 newborns were found to have hearing impairment among 426 newborns. APGAR ≤ 6 at 5 minutes (odds ratio 20.34, p-value 0.01), TORCH infection (odds ratio 0.64, p-value 0.01), IUGR odds ratio 8.92, p-value 0.02) were independent significant risk factors for hearing impairment. Conclusion: APGAR ≤ 6 at 5 minutes, TORCH infection, and IUGR are independent significant risk factors for newborn hearing impairment. Newborns in NICU with these risk factors should have mandatory audiological evaluation. TAJ 2022; 35: No-2: 59-65

Background: Adequate nutrition during infancy and early childhood are essential to ensure growth and development, and it depends significantly on the pattern of complementary feeding. As Bangladesh is a high burden of infant malnutrition, the present study was designed to assess the practices regarding complementary feeding among mothers attending a tertiary care hospital.  Objective: To observe the attitude and practices of mothers regarding complementary feeding.  Methodology: This cross-sectional study was conducted at the Department of Pediatrics in Rajshahi Medical Hospital for one year. A total of 227 mothers of children aged between 6 to 24 months attending pediatric OPD at Rajshahi Medical Hospital were included in this study. Data collection was conducted through a pre-designed questionnaire. After data collection of data, data were analyzed by SPSS 23.0. Results: A total of 227 parents were interviewed. The mean age of the respondents was 26±8.42 (SD) years. Nearly half (45%) of the mothers belonged to lower-middle-income families. Of all, 82% of the mothers knew about the perception of complementary feeding, and about 21% knew the WHO recommended age for complimentary food initiation (at six months). About 71% and 60% had knowledge about iron-rich food and iodized salt accordingly. Half of them knew the appropriate consistency of complimentary food. About 64% of mothers gave complementary foods ≤2 times a day while 36% fed≥3 times a day. Regarding attitude, 78% of mothers approached the necessity of maintaining dietary diversity and variety of food for a balanced diet. In comparison, 52% preferred homemade food, 22% preferred commercially available food, and 26% preferred a combination of both. About 71.8% of mothers believed in different food taboos. In this study, dilution of cow's milk as a complementary food was done by 76% of mothers, while complementary feeding was discontinued by 80%. About 78% and 65% of the mothers reported washing their hands and utensils and baby's hand before feeding the child, 66% of them covered the food after cooking, and 43% reheated the food before serving. Conclusion: This study shed light on existing knowledge, attitude, and practice among mothers attending a tertiary care hospital. But to get the exact scenario, further extensive study is recommended. TAJ 2022; 35: No-1: 83-90

Background : Complex anorectal fistula may be endowed by the level at which the primary tract crosses the sphincters, the presence of secondary extensions or the difficulties faced in the treatment. Existing different treatment modalities like local advancement flap, LIFT procedure, fistulotomy and use of seton. Surgeons are afraid of incontinence in treating complex anorectal fistula. The aim of treatment of anal fistula is to cure the disease avoiding faecal incontinence. Among different procedures, Seton, a thread of foreign material, passed through the fistulous track and encircling sphincter mass thereby severing the muscle gradually without allowing it to spring apart and replacing the cut by the line of fibrosis thus avoiding incontinence, is an acceptable method practiced world wide. The purpose of the study is to evaluate and share our experience with others about the result of using seton in the treatment of complex anal fistula in our setting. Method: Between January 2003 and December 2008, I have taken the 1st 100 patients underwent surgery for complex anal fistula in Colorectal Surgery Unit of Bangabandhu Sheikh Mujib Medial University, Dhaka. It involved initial identification and partial laying open of the fistulous tract. A tight seton is placed around the external sphincter and is not removed until the internal orifice has migrated towards the perianal skin. Results: Out of 100 patients with mean age 43 years (range 19-65 years) 6 female and rest male underwent the procedure of seton. The median follow-up was 28.6 (24-36) months. The mean time of wound healing was 9.5 weeks (range 6-15). Recurrence occurred in two patient (2%). Continence disorders of flatus and loose stool were noted in 14 patients (14%). The duration with the seton in place was 56 days (range 20-190). Conclusion: The technique shows excellent results in the treatment of complex anal fistulous with preservation of faecal continence. Journal of Surgical Sciences (2013) Vol. 17 (1) : 14-17