HighlightsEpidermoid cyst in the breast is very rare.We report here the largest epidermoid cyst in the breast ever published.Epidermoid cyst in the breast is difficult to differentiate clinically from other benign breast disorders, so imaging and cytology is essential.There is risk of complications like malignant transformation in case of giant epidermoid cyst.Total excision along with its capsule is recommended to prevent recurrence.

This study investigated the knowledge and attitudes towards COVID-19 in Bangladeshi adults by online and phone survey methods during the early stage of its spread.Methods: Data were collected through phone calls (April 14-23, 2020) and online survey (April 18-19, 2020) in Bangladesh. The questionnaire had 20 knowledge questions with each correct response getting one point and incorrect/don't know response getting no point (maximum total knowledge score 20). Participants scoring >17 were categorized as having good knowledge. Results:The percentages of good knowledge holders were 57.6%, 75.1%, and 95.8% in the phone, online non-medical, and online medical participants, respectively. Most of the phone and online participants had good knowledge of the preventive practices of COVID-19. However, among the non-medical participants (both phone and online), the correct response rates were lower than 80% for the knowledge questions asking about the facts that -some patients may have no symptoms, diarrhea is a symptom of this disease and that it cannot be prevented by any currently available medication. Male gender, higher education, living in town/urban areas, good financial condition, and use of internet were positively associated with higher knowledge score among the non-medical participants. However, higher knowledge score was associated with having less confidence in the final control of COVID-19. Conclusion:Our study identified some COVID-19 information that were less known among the participants and the potential factors that were associated with having good versus poor knowledge. Besides, this study sheds light on the attitude of Bangladeshi adults towards COVID-19.

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.

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Introduction During the COVID-19 pandemic, healthcare workers had a high workload and were exposed to multiple psychosocial stressors. However, a knowledge gap exists about the levels of burnout among Bangladeshi frontline doctors during this COVID-19 pandemic. The study investigated burnout syndrome (BOS) among frontline doctors in two public secondary and tertiary care hospitals in Chattogram, Bangladesh. Materials & methods This cross-sectional study involved frontline doctors working at two hospitals treating COVID-19 and non-COVID patients from June to August 2020. A self-administered questionnaire that included Maslach Burnout Inventory for Human Services Survey (MBI-HSS) was used to capture demographic and workplace environment information. ANOVA and t-test were used to determine the statistical differences in the mean values of the three dimensions of MBI-HSS. Scores for three domains of burnout: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA) were calculated. Post-hoc analysis was done to identify the significant pair-wise differences when the ANOVA test result was significant. Multiple logistic regression was performed to determine the influence of factors associated with BOS. Results A total of 185 frontline doctors were invited to participate by convenience sampling, and 168 responded. The response rate was 90.81%. The overall prevalence of BOS was 55.4% (93/168) (95% CI: 47.5% to 63.0%). Moderate to high levels of EE was found in 95.8% of the participants. High DP and reduced PA were observed in 98.2% and 97% of participants. Younger age (25–29 years), being female, and working as a medical officer were independently associated with high levels of burnout in all three domains. EE was significantly higher in females (P = 0.011). DP was significantly higher in medical officers, those at earlier job periods, and those working more than 8 hours per day. Conclusion During the COVID-19 outbreak, BOS was common among Bangladeshi frontline doctors. Females, medical officers, and younger doctors tended to be more susceptible to BOS. Less BOS was experienced when working in the non-COVID ward than in the mixed ward.