Background: Failed hypospadias refers to any hypospadias repair that leads to complicationsor causes patient dissatisfaction. One of the commonest major complications of hypospadias surgery is urethrocutaneous fistula. Objectives: Present study aimed to determine a better procedure of salvage urethroplasty for failed hypospadias, caused by persistentlarge (>4mm) or multiple -small (<4mm) fistulae, by a randomized comparison. Patients and Methods. This interventional study was performed in the department of Paediatric Surgery, Rajshahi Medical College Hospital, Rajshahi, Bangladesh, over a period of five years (from July 2011 to June, 2016). A total of 189 patients were included in present study and randomized in the three groups under study. Comparisons were made among three procedures of salvage urethroplasty of failed hypospadias caused by urethrocutaneous fistula using substitution of dorsal skin flap, Flip flap, or buccal mucosal graft in a controlled situation. Outcomes were assessed by means of objective scoring system. Results: Refistula rate, devascularization of flap and grafts and wound dehiscence rate were significantly less in Buccal mucosal graft (group A) than flip flap(group C) and dorsal transposition flap (group B ). This led to a higher success rate and better patient compliance in buccal mucosal graft. The objective scoring evaluation revealed that score gain of BM group (182) was significantly higher than that of dorsal transposition flap (112) and flip flap (89) at P value <0.05 . Conclusion: Staged redo urethroplasty for large or multiple-small fistulae using substitution of buccal mucosal graft revealed as an better option for urethral reconstruction than dorsal transposition flap and flip flap procedures (group A˃ group B ˃group C). TAJ 2018; 31(1): 38-45

An assessment was carried out to observe the impacts of fish sanctuary on the livelihoods from fishers of Ruhul beel and Bamonji beel under Chalan beel in Pabna district of Bangladesh. Data were collected from selected sanctuary sites with prepared and pretested questionnaire and analyzed through statistical tests like ANOVA (Analysis of Variance), regression, correlation, Chi-square were used to identify the relationships between variables and significant differences/association among them. From physical capital point of view, it was found that 91.3% of fishermen’s houses were katcha, 6.52% were semi-pacca, and only 2.17% were pucca in case of Ruhul beel and in case of Bamonji beel 90.54% of fishermen’s houses were katcha, 8.11% were semi-pacca, and only 1.35% were pacca. There was no significant variation (ANOVA; P>0.05, Chi Square test; non-significant at 0.05 level) among the residences by well-being. From human capital, average age of the household heads (HHH) was 37.95(±) 1.354 for Ruhul beel respectively, whereas for Bamonji beel the average age were 38.05(±) 1.064. The medium aged group fishermen were dominant in Ruhul beel than Bamonji beel. There were no significant difference (P>0.05) found between the age groups by well-being. From income capital it was observed highest part of income were come from fishing contributing 64.89% (653.72±128.82 US$), 43.58% (431.89±74.66 US$) for Ruhul beel and Bamonji beel respectively. As per as natural and social capital, average used land holding was 0.274±0.136 ranging 0.065 ha to 0.534 ha for Ruhul beel and 0.228±0.305 ha ranging 0.040 to 0.267 ha for Bamonji beel. The average land holdings did not vary significantly (P>0.05) between the sites. Asian Australas. J. Biosci. Biotechnol. 2020, 5 (3), 100-114

Background: Laparoscopic appendectomy is considered as a superior alternative to open appendectomy. Usual laparoscopic appendectomy is performed with the three port system. In this study, we performed a unique single transumblical incision two-port laparoscopic assisted appendectomy with the aim to reduce postoperative complications as well as improving cosmesis and patients' satisfaction. Methods: From January 2010 to December 2011, 136 patients were admitted with clinically diagnosed acute appendicitis and were randomly assigned to single transumblical incision two-port laparoscopic assisted appendectomy. Result: Transumblical single incision two-port laparoscopic assisted appendectomy was attempted in all patients (52 males and 84 females) with an average age of 8.5 years. Transumblical single incision two-port laparoscopic-assisted appendectomy was successfully completed in 134 patients. In two patients, another additional port was required due to sever adhesion of the appendix. Mean operation time was 25.2 min (range, 17-38), and mean postoperative hospital stay was 2 days (range 1-3). Postoperative complications were negligible. Conclusion: Transumblical single incision two-port laparoscopic-assisted appendectomy appears to be a feasible and safe technique for the treatment of acute appendicitis in the paediatric setting. It allows nearly scar less abdominal surgery.

Posterior urethral valves (PUV) constitute the most common infra-vesical urinary obstruction in boys. PUV are often accompanied by severe consequences to the lower and upper urinary tract (LUT, UUT). They also represent a major urological cause for pediatric renal transplantations. Surgical options for primary management invariably aim at abolition of valves. However, temporary urinary diversion may sometimes be a viable alternative, especially in critically ill patients or preterm infants. It was a retrospective, descriptive study which was conducted at the Department of Pediatric Surgery, Rajshahi Medical College from January 2018 to December 2018. All stable patients with the diagnosis of posterior urethral valves were included in the study. Endoscopic valve fulguration was performed in all diagnosed patients using bugbee electrode and an adequate sized cystoscope. The procedure was performed under general anesthesia and the urinary bladder was drained with a suitable size Foley's or silicon catheter for 14days. Patients were discharged from the hospital 48-72 hours after the procedure on oral antibiotics and were advised to come to the outpatient department for follow up visits for a period of 6 months. A total of 84 patients were included in the study. All were males with a mean age of 6.5years ranging from 6 months to 12 years. Sixty five patients were without any diversion while 19 had vesicostomy or ureterostomy already done in our department or somewhere else. Stricture urethra was seen in 5 patients, incontinence of urine was seen in 7 patients, nocturnal enuresis in 15 patients and recurrent urinary tract infection in 19 patients. Chronic renal failure was seen in 4 patients while 16 patients lost the follow up.18 patients had an uneventful recovery. Urethral valve ablation is the definitive treatment of posterior urethral valves. Endoscopic urethral valve fulguration is safe, effective and definitive way of management for posterior urethral valves. Early treatment improves the quality of life and prevents the ongoing renal damage. Early presentation in fetal and neonatal life has worst prognosis due to associated renal dysplasia. TAJ 2018; 31(2): 68-72

Objective: To study the presentation, management, histopathological findings and outcome of undescended testes in children. Method: It was a prospective study done in Rajshahi Medical College Hospital and also private clinic in Rajshahi Metropolitan City during the period of 1st December, 2007 to June, 2010. Thirty two children aged 4 months to 13 years with 40 undescended testes were selected in this study. Interventions like Orchidopexy, orchidectomy, herniotomy were done.Results: The age at surgery was four months to 13 years (mean 5.25 + 0.61 SE years). Nine (28.13%) had corrected before two years, twenty three (71.87%) after two years. Twenty four testes (60%) were palpable and sixteen (40%) were non-palpable, none of then cases was diagnosed at birth. Ultrasonography was performed in all cases. Evaluation was done by clinical, sonological, pre-operation and histopathological findings, Laparoscopy was done in one case. The condition was unilateral in 24(75%) and bilateral in Eight (25%). Forty percent of the testes were in the inguinal canal, 34% at the external ring and 10% at the internal ring and 16% in the abdomen. Fifteen (46.87%) testes were macroscopically smaller in size, four (10%) testes were atrophic (all were canalicular), one was tumour. Orchidopexy was performed in for 35 undescended testes and orchidectomy for five. Scrotal haematoma developed in 2 cases. Histopathological finding showed no spermatogonia in 25 (78.12%), among then 23 were above 2 years, 2 were below 2 years. Follow-up period were 6 months to 18 months, no atrophy/retraction was observed.TAJ 2017; 30(2): 26-31