Mammary tuberculosis is a rare entity in western countries but a continuing problem in endemic areas like Bangladesh. Its clinical patterns and treatment strategies are changing day by day. In this study we showed our clinical experience on 50 cases of mammary tuberculosis. This is a prospective nonrandomized observational descriptive study. A total of 50 consecutive adult female patients with no other co morbid diseases and who were diagnosed cytologically or histologically as case of mammary tuberculosis were enrolled in the study over a period of 04 years since 2006 to 2010 in general surgical unit of Chittagong Medical College Hospital and Chittagong general hospital. The average ages of presentation were 38 years. Ten(20%) patients were lactating at the time of presentation and six(12%) patients were nulliparious. 40(80%) patients had breast lump at presentation. Among them 20(40%) presented with multiple sinuses with lump,10(20%) had abscess with lump,05(10%) had abscess drainage scar with underlying lump and 05(10%) presented with isolated breast lump.06(12%) presented with multiple sinuses with abscess formation. Another 04(8%) patients had multiple sinuses only at presentation. Ten (20%) had constitutional symptoms in the form of fever, weight loss and night sweat. Twenty (40%) had axillary lymphaedenopathy in association with breast lesion. Diagnosis were confirmed by cytological and or histological findings of epitheloid granulomas.All patients were given antitubercular chemotherapy ( 9 months regimen) in combination with surgical intervention (45 out of 50 cases) as necessary in the form of excision of masses, incision and drainage of abscess and sinectomy. Mammary tuberculosis is a continuing problem in developing countries. Presentation may mimic benign lesion or carcinoma of the breast. Diagnosis can be made on high index of suspicion in endemic areas. Cytological or histological findings of granulomatous inflammation consisting of caseation necrosis, epitheloid cell and Langhans giant cell can give definitive diagnosis. Treatment is by anti tubercular chemotherapy with or without surgical intervention where necessary.

Background: Laparoscopic Cholecystectomy (LC) has become the treatment of choice for symptomatic gallstone disease. But it becomes difficult to perform safely and some cases require conversion to Open Cholecystectomy (OC). There is no clear consensus among the laparoscopic surgeons to determine preoperative parameters that can predict difficult laparoscopic cholecystectomy. The aim of this study is to predict the difficult laparoscopic cholecystectomies by correlating with preoperative clinical and radiological findings. Materials and methods: This prospective observational study was performed in the Department of Surgery at Chittagong Medical College Hospital for a period of one year from April 2018 to March 2019. The sample size was 151. Pre-operative clinical and ultrasonographic criterias were correlated with intraoperative difficulties encountered. Peroperative difficulties were considered in terms of pericholecystic adhesion, difficult callots triangle dissection, difficult GB bed dissection and unusual bleeding during surgery. Results: Out of 151 patients underwent LC in this study; 93 (61.6%) cases the procedure was uneventful and the other 58 (38.4%) procedures were difficult. Among those difficult 58 cases, 13 (8.6%) patients required conversion to open cholecystectomy. Difficult LC were found in BMI >30kg/m2, hospitalization for 3 or more times due to acute painful attack and GB wall thickness >3 mm. Conclusion: Pre-operative prediction of difficult LC can be determined by correlating with clinical and radiological findings that help the surgeons to better prepare for intra-operative difficulties and risk of conversion to open cholecystectomy. IAHS Medical Journal Vol 4(2), December 2021; 70-73

Background: Lower urinary tract symptoms suggestive of symptomatic Benign Prostatic Hyperplasia (BPH) are a very common disease in elderly men .The incidence of benign prostatic hyperplasia is age related. Objectives: To compare the efficacy and safety of Tamsulosin and Terazosin in the treatment of symptomatic Benign Prostatic Hyperplasia. Methods: This was a prospective study carried out in the Department of Urology, Chittagong Medial College Hospital, Chittagong, Bangladesh during the period of July to December 2014. Total 40 patients of 45-80 years of age were consequently selected according to inclusion criteria. After completion of baseline clinical evaluation and investigations, participants were divided into two groups, group A and group B. Group A (n=20) was given Terazosin 1mg daily for 3 days at bed time and then 2 mg daily at bed time for 2 months. Group B (n=20) was given Tamsulosin, 0.4 mg per day for 2 months. Efficacy was evaluated of each group after 2 month follow up and lastly a comparison was made between them. The parameters monitored were International Prostate Symptoms Score (IPSS) Maximum urine flow rate (Qmax) and Post Voidal Residual Volume (PVR). Tamsulosin 0.4 mg and Terazosin 2 mg once daily for 8 weeks both are effective in relieving symptoms of BPH but Tamsulosin is superior to Terazosin in improvement of total IPSS (p<0.001) and Qmax (p<0.01) PVR (p<0.01) at the end point. Results: Outcome of parameters at follow up after 2 months. Tamsulosin group showed significant improvement of IPSS (p<0.05) PVR (p<0.001) and Qmax (p<0.001) than Terazosin. The incidence of adverse events by administration of Tamsulosin was less than that by Terazosin. Conclusion: Tamsulosin appears to have more efficacy and safety than Terazosin in symptomatic BPH.