Preterm low birth weight (LBW) babies are unable to control their body temperature and are at greater risk of illness. Kangaroo Mother Care (KMC) is special ways of caring for low birth weight babies. KMC provide thermal care through continuous skin to skin contact, support for exclusive breast feeding and early recognition and response to complication. The aim of the study is to assess thermal control, morbidities feeding pattern of baby getting KMC in comparison to conventional care. The study also give estimation about duration and cost during hospital stay and growth between the babies of two groups. This Randomized Controlled Trial was conducted in the Department of Neonatology, BSMMU, Dhaka from December 2012 to October 2013. Fifty neonate with birth weight 1250 to 1800 gm, gestational age >30 weeks to <37 weeks, Hemodynamically stable after birth were selected. Twenty five of them were randomly allocated to KMC(Group-I) and 25 of them to Standard Method Care (Group-II). The mother or care giver provided KMC at least 12hours/day in Group-I. Those in Group-II were managed under radiant warmer. During hospital stay both the groups were monitored and after discharge, the neonates were followed weekly till 40 weeks of corrected gestational age. There were no differences in birth weight, gestational age, number of male/female neonates, places of delivery and mode of delivery between two groups. During hospital stay hypothermia (Group-I 4% vs Group-II 24%) and hyperthermia (Group I 8% vs Group II 32%) were significantly low in KMC group. Late onset neonatal sepsis (LONS) developed significantly in Group-II. Though incidence of culture negative LONS did not differ in two groups but incidence of blood culture positive LONS was significantly high in standard care neonates (36% vs.0%; p=0.001). Neonates with KMC care required significantly shorter time to reach full feeding and to start direct breast feeding; also incidence of feeding intolerance was significantly lower in this group. After initial loss, weight gain started earlier as well as achieved the birth weight earlier in KMC group. Morbidities like hyperglycaemia and apnoea were significantly higher in standard care group. Neonates who received standard care stayed significantly longer in the hospital and total cost during hospital stay was also significantly higher in this group. At 40 weeks corrected gestational age, KMC infants showed significantly higher daily weight gain than standard care group. This study concluded that Kangaroo Mother Care provides effective thermal control, decreases the incidence of sepsis, improves feed tolerance, helps to achieving full enteral feeding and birth weight earlier in preterm LBW neonates. KMC enhances growth during postnatal period. KMC also found to reduce hospital stay and treatment cost. Proper implementation of KMC for the management of preterm  low birth weight babies is safe and effective care. Bangladesh Med J. 2018 Jan; 47 (3): 1-8

Background: Avascular necrosis (AVN) of the femoral head usually occurs in the active age of life, and is an increasingly common cause of musculoskeletal disability. Objective: we envisage to evaluate and compare the clinic oradiological outcomes between TFL muscle pedicle bone graft and no vascularized fibular grafting after core decompression prior to hip joint involvement of AVN femoral head provides painless and mobile life. Method: January 2013 to December 2019, total 64 hips (44 patients) in the age group of 18-48 years (mean 30.36±4.64 years) were included in this prospective study. Ficat and Arlet staging system was used, Stage I (n=10 hips), Stage II (n=44 hips) and stage III (n=10) of AVN of femoral head, were included after clinical and radiological evaluation, where 32 hips (half of all stage-I, II and III) were treated with fibular graft (Group 1) and rest 32 hips were treated with TFL muscle pedicle bone graft (Group 2) after decompression of femoral head. Preoperative Harris Hip Score (HHS), visual analog score (VAS), plain radiographs, and magnetic resonance imaging (MRI) were compared with serial postoperative HHS, VAS, plain radiographs at regular interval. The average follow up was 56 months. Result: Out of 44 patients, male was 28 (63.64%) and female was 16 (36.36%). Failure of surgery was defined as progression of the disease, which was n=1,10% (1/5, 20% in group 1, 0% in group-2) in stage I, n=12/44, 27.27% (7/22, 31.82% in group-1 and 5/22, 22.73% in group-2) in stage II and n=5/10, 50% (2/5, 40% in group 1 and 3/5, 60% in group 2) in stage III disease. Median values of HHS at the end of the follow up in Group I was 80 and 76 in Group 2, compared to the preoperative HHS of 56 and 52 respectively.. Overall satisfactory result was 71.88%, p value was <0.01, that is significant. In group 1 satisfactory result was 22/32 (68.75%) but 24/32 (75%) in group 2, no statistical significant difference (>0.05) between two groups. Even in early stage III disease, only 50% was effective. Conclusion: Core decompression with bone graft is effective in preserving the sphericity of the femoral head and to delay the progression in the early stages of the AVN of femoral head, (Stage I and II), fibular graft gives early stability but long term results are similar in both group.

The hand grip is severely impaired following high radial nerve palsy due to loss of extension of the wrist, metacarpo- phalangeal joint of fingers and thumb. If radial nerve does not show neural recovery following conservative or surgical repair during the optimum time, tendon transfer is considered the standard treatment. To evaluate and compare the clinical outcome between flexor carpi radialis and flexor carpiulnaris tendon transfer for fingers’ extension in high radial nerve palsy. This randomized controlled trial study was carried out in the Department of Orthopedic Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka over a period of two years from January 2013 to December 2014. A total of 30 patients with high radial nerve palsy were recruited, 15 patients were gone through Flexor Carpi Radialis tendon transfer procedure (FCR group) and the rest 15 patients were gone through Flexor Carpi Ulnaris tendon transfer procedure(FCU group). The patients were followed up for 12 weeks after surgical intervention. Out of all patients, 86.7% male were encountered in each group. The mean age was found 31.07±9.14 years in FCR group and 33.60±10.79 years in FCU group. Humerus fracture was remained a major cause of radial nerve palsy in both FCR and FCU groups (26.7% vs. 33.3%). In final follow-up at 12th week, no extension deficit was observed at MCP joint (93.3% vs. 80.0%, p>0.05).The end result of surgical intervention was found satisfactory equally in both the groups (86.7%). In case of high radial nerve palsy, both FCR and FCU tendon transfer procedures are effective forfingers’ extension at MCP joint. Bangladesh Med J. 2019 Sep; 48 (3): 9-15

<p><strong>Background:</strong> Cubitus varus is the most common angular deformity resulting from supracondylar fracture of the humerus in children and adults. There are several options for correcting this deformity, but three dimensional osteotomy is now a popular method for the operative treatment of cubitus varus deformity. Objective of current study was to evaluate clinical and radiological outcome of three dimensional corrective osteotmy for cubitus varus deformity.</p><p><strong>Methods</strong>: This prospective interventional study was conducted in the department of orthopaedic surgery, BSMMU, Shahbag, Dhaka from January 2016 to September 2020. Within this period, total 40 cases of cubitus varus deformity, age ranging from 8-20 years that has the inclusion criteria was enrolled as a study sample with proper consent. All the data were analyzed statistically by using SPSS-22.</p><p><strong>Results:</strong> The results of present study showed significantly improved carrying angle, range of motion, internal rotation angle at the time of final follow-up period of six months or more. The outcome of the subjects was graded as excellent in 16 (40%), good in 18 (45%), fair in 4 (10%) and poor in 2 (5%) patients. Excellent, good and fair results were considered as satisfactory outcome and only poor result was considered as unsatisfactory outcome.</p><p><strong>Conclusions:</strong> After analyzing the results of present study it can be concluded that three dimensional osteotomy is a safe technique with satisfactory outcome in treatment of cubitus varus deformity.</p>

J Dhaka Medical College, Vol. 21, No. 2, October, 2012, Page 211-217 DOI: http://dx.doi.org/10.3329/jdmc.v21i2.15361