Poisoning is a common medico-social problem in our country causing around 300,000 episodes and around 2000 death per year. The number of poisoning cases is increasing in our country day by day. The common pattern of poisoning in our country is suicidal, homicidal/criminal and accidental. The incidence, nature, etiology, age group affected and the outcome of poisoning in our country is different from that of the western world. A prospective descriptive study of poisoning cases in Sir Salimullah Medical College and Mitford Hospital was attempted in 2004.Among 100 cases, age of the cases ranged from 15-65 years. Sixty four percent were male. Around 68 percent cases were found businessman, 48% were from low-income group and Fifty three percent cases were educated up to secondary level.Among male patients 57.81% of poisoning caused by suspected sedative poisoning (transport related poison), 28.12% by organophophorous, 3.12% by copper sulphate, 4.98 by benzodiazepines (attempted suicide), 4.98% by Acid and 1.56% by kerosene. Among female patients 41.66% of poisoning caused by organophosphorous compounds, 19.44% by rat killer, 11.11% by copper sulphate, 8.33% by benzodiazepines, 5.55% by acid, 5.55% by savlon, 5.55% by herpic and 2.77% by phenol.Transport related poisoning by short acting sedative-hypnotics for the purpose of hijacking the belongings of the travelers and agrochemicals-organophosphorous compounds for suicidal purpose are the most common poisoning in our country. The pattern and magnitude of poisoning are thus multidimensional and demanding multi-sectoral approach for facing the problem. The comprehensive patient care can improve the poisoning case management in our country. DOI: 10.3329/jdmc.v17i2.6593J Dhaka Med Coll. 2008; 17(2) : 111-115

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Reconstruction of scalp and calvarial defects following trauma post burn and after tumor ablation frequently requires prosthetic cranioplasty and soft tissue coverage. Furthermore, patients often have advanced disease and receive perioperative radiotherapy following tumor ablation. We evaluated the outcome of scalp reconstruction in traumatic cases with a free Latissimus dorsi (LD) muscle flap in this setting. The aim of this study was to evaluate outcome of latissimus dorsi free flap in-case of large scalp defect. This prospective non-randomized study was conducted on 10 patients with scalp defects following trauma attended emergency unit and outpatient department of burn and plastic surgery, Dhaka medical college hospital (DMCH) in the period between July 2017 and June 2018. Durability of coverage, flap success, infection and overall satisfaction were studied. The age distribution of the study population shows highest number of patients (60%) were in middle (24-30 years) age group whereas lowest are in older group (30-50 years). The lowest age was 24 years and the highest age was 45 years. Highest number of patients (80%) were standard myocutanous type of flap whereas lowest were in (20.0%) were partial latissimus muscle flap. Outcome of the reconstruction (80.0%) were excellent 10% partial flap necrosis occur and total flap loss in 1 (10%) patient. The reconstruction of scalp defects continues to be a challenge for the reconstructive surgeon, who must achieve a satisfactory functional and aesthetic outcome.

Pseudohypoparathyroidism (PHP) is a rare hereditary  disorder having the prevalence of 3.4 per million. It is  characterized by symptoms and signs of  hypoparathyroidism, typically in association with distinctive  skeletal and developmental defects. The features of  hypoparathyroidism are due to tissue resistance to the effect  of parathyroid hormone (PTH). We will describe a 32-yearold  woman who had recurrent convulsion for 16 years,  infertility, cataract, psychosis, candidiasis and typical  features of Albright’s hereditary osteodystrophy (AHO),  which include a round face, short neck, short stature and  brachydactyly. Laboratory investigations showed  hypocalcemia, hyperphosphatemia with high PTH level.  Computed tomography scan of head revealed wide spread   calcification in basal ganglia and cerebral hemispheres. X  ray of left foot showed short left 4th metatarsal bone. The  patient was diagnosed as a case of PHP on the basis of  somatic features of AHO with typical biochemical  abnormalities and uncontrolled convulsion with combined  antiepileptic drugs for 16 years. The unusual features in our  case are long delay in clinical diagnosis and absence of family  history. She was treated with calcium salt and vitamin D.  With this treatment patient’s condition was improved and she  experiences no attack of convulsion and carpal spasm.  Anticonvulsants were withdrawn gradually. We recommend  that hypocalcaemia should be excluded before commencing  anticonvulsant therapy in all epileptic patients and those  patients whose seizures are refractory to anticonvulsant drugs   DOI: http://dx.doi.org/10.3329/jbcps.v29i4.11331   J Bangladesh Coll Phys Surg 2011; 29: 227-230

Reconstruction of the legs and feet is challenging. Because of the composite tissue defects, inadequate and tight local tissues and poor circulation, soft tissue scarcity around the lower portion of the leg presents a significant challenge to the reconstructive surgeon. The aim of this study was to assess the outcome of free Lattismus dorsi (LD) muscle flap used for soft tissue reconstruction of leg defects. This prospective non-randomized study was conducted on 13 patients with leg defects of different causes attended emergency unit and outpatient clinic of plastic surgery department of plastic surgery and burn unit, Dhaka medical college hospital (DMCH) in the period between July 2017 and June 2018. Durability of coverage, flap success, infection and overall satisfaction were studied. The age distribution of the study population highest number of patients (46.15%) were in middle (31-40 years) age group whereas lowest are in older group (>51 years). Highest number of patients (84.61%) were standard myocutanous type of flap whereas lowest were in (15.31%) were chimeric flap and partial latissimus muscle flap. There were one case of total flap loss. Two patients had seroma formation among them one patient had partial necrosis. The outcome of reconstruction of n=13 patients 76.92% patients discharged with excellent recovery, (15.38%) patients discharged with good outcome, 1 (7.69%) patients had total flap loss. Flap is easy to dissect, anatomical variation is rare, long pedicle length which allow to anastomose with suitable recipient artery and finally donor morbidity is negligible.