Background: Breast abscess is defined as an acute inflammatory lump which yields pus on incision/aspiration. The frequency of occurrence is highly related to pregnancy and caused due to nipple cracking by a child during breast feeding and bacterial colonization due to improper nursing technique and incomplete emptying of the breast. Objective: The present study compares the outcome and effectiveness of traditional treatment incision and drainage against needle aspiration in the treatment of breast abscess. Methods: This is a comparative study carried out in department of general surgery, SherE- Bangla Medical College Hospital, Barisal between January 2014 and December 2014. 50 female patients of age between 20-40 years and diagnosed breast abscess with abscess size of 5'7 cm in diameter on ultrasonography were included in the study after taking written consent form. Of these 25 had undergone aspiration of the breast abscess (group A) and 25 had undergone incision and drainage (group B). Results: The mean age of the female patients in group A was 23.42 years and in Group B was 23.31. 91% of the cases were lactating. S. aureus was the common organism isolated in both lactating and non-lactating cases, encountered in 27 patients (54%). Out of that were in the aspirated group 17patients (56.67%). 10 patients were in the incised group (33.33%). The mean healing time and cosmetic outcome was significantly (p =0.001) very good in patients treated with needle aspiration compared to incision and drainage. There was no recurrence of breast abscess observed in needle aspiration group during the study. There was 3.3% recurrence rate observed in the incision and drainage group. Conclusion: Breast abscess in patients with diameter of 5'7 cm can be treated with needle aspiration successfully and with a good cosmetic outcome. Journal of Surgical Sciences (2018) Vol. 22 (1): 11-15
Aim: To compare Desarda’s versus Lichtenstein’s mesh repair in patients with unilateral, primary, reducible inguinal hernia in terms of mean operative time and seroma formation Methods: This randomized control trial conducted at Department of Surgery, Patuakhali Medical College & Hospital, Patuakhali. Eighty patients with unilateral, primary, reducible inguinal hernia were randomly distributed into two groups to undergo hernia repair i.e. Lichtenstein (L) and Desarda’s (D). Outcome was measured in terms of mean operative time and seroma formation. Seroma formation was defined as presence of enclosed cavity containing serous fluid determined by ultrasonography at 30th post-operative day. Results: Thirty three patients (41.25%) were above 50 years of age, whereas remaining 47 patients (58.75%) were below 50 years of age. Five patients (6.25%) were female and 75 patients(93.75%) were male. Seroma formation was 5% in Desarda’s group while 7.5% in Lichtenstein group (P> 0.05). Similarly difference in mean operative time was statistically non-significant. Seroma formation was common in older age group. There was no effect of smoking, obesity, operative time and gender on seroma formation. Conclusion: It is concluded that there is no difference in frequency of seroma formation and mean operative time in Desarda’s or Lichtenstein’s technique of hernia repair. Journal of Surgical Sciences (2018) Vol. 22 (2) : 99-103
Introduction: Peritonitis secondary to gastrointestinal perforation is one of the commonest surgical emergencies encountered all over the world. This study was done to highlight the spectrum of perforation peritonitis encountered in surgery unit of Dhaka Medical College Hospital. Method: It was observational prospective of 100 cases of perforation peritonitis treated in our hospital. All cases of perforative peritonitis whether spontaneous, infective or neoplastic pathology were included in this study. Results: The maximum numbers of patients were in age group between 31 to 40 years (39 %) with mean age 35 years. Male female ratio was 9:1. The most common aetiology of perforation peritonitis was peptic ulcer disease (73%) followed by enteric fever (12%), appendicitis (10%), tuberculosis (3%) and malignancy (2%). The most common sites of perforation were in descending order of frequency - first part of the duodenum (65%), terminal ileum (12%), appendix (10%), gastric antrum (9%), jejunum (3%) and rectum (1%). Abdominal pain (100%) and vomiting (81%) were the most common symptoms while tachycardia (96%), muscle guard and rigidity (100%) were the common signs. Approximately 15-20% presented late with features of shock. Mortality rate was 2% and was significantly high in patients coming hospital late. Conclusion: Gastrointestinal perforations are one of the most common surgical emergencies. Duodenal perforations are most common. Ileal perforations secondary to enteric fever have highest morbidity. Early recognition and timely appropriate intervention is very important in reducing morbidity and mortality. J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 106-109
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