Tracheostomy is one of the most frequent procedures performed in intensive care unit (ICU) patients. It has many advantages like patient’s comfort, early movement from the ICU, and shorter ICU and hospital stay. Of the various techniques, we practice bedside open procedure tracheostomy for ICU patients considering the safety and cost effectiveness.Aim: To observe the common indications and timing of tracheostomy in our circumstances.Method: This cross-sectional study was carried out in 11 ICUs of Dhaka city from January 2008 to June 2015. All ICU patients, irrespective of age and sex , whose tracheostomy were done after admission in ICU at bedside by the principal author with associates were included in this study.Result: Bedside conventional tracheostomy was done in 345 ICU patients during the study period. Among them, 65% were male and 35% were female. Mean age of the patients was 44.30. Common indications for tracheostomy were cerebro-vascular disease (36%), laryngeal oedema (20%), advanced malignancy (16%), and trauma (12%). Only 54 patients had complications like hemorrhage (6%), surgical emphysema (3%), tube displacement (3%), wound infection (2%) and pneumothorax (1%).Conclusion: Bedside conventional tracheostomy is safe and efficient with low morbidity. Mortality is not worse and may be improved with earlier provision, especially in head-injured and critically ill medical patients. The timing of tracheostomy continues to be individualized, and should include daily weaning assessment, and can generally be made within 7 days of endotracheal intubation.Bangladesh Crit Care J September 2016; 4 (2): 65-68

A 50-year-old diabetic female attended in September, 2021 with a huge swelling in front of her neck, respiratory distress, hoarseness of voice, & generalized weakness for 1 month. All the biochemical tests were inconclusive but S. calcitonin was high(>0.08ng/ml), Fiber optic laryngoscopy revealed left vocal cord paralysis, X-ray chest revealed right sided tracheal deviation, CT-scan of Neck revealed large solid mass in thyroid with mediastinal extension & cervical lymphadenopathy. Patient undergone total thyroidectomy. The specimen sent for histopathology and revealed medullary carcinoma of thyroid gland. AKMMC J 2021; 12(2): 104-106

The aim of this study was to assess hearing improvement after myringoplasty within ten weeks following surgery. The study population consisted of 30 patients who were suffering from CSOM-77". Pre-operative and post-operative eraminations of the patients were conducted clinically as well as audiologically. Pre-and post-operative air-bone (A-B) gap were calculated by raking the averages of bone conduction and air conduction at the frequencies of 300. 1000 and 2000 Hz. Myringoplasty was done with underlay technique under general anaesthesia by postaural approach. Temporal 'muck fascia was used as grafting material for reconstruction of the tympanic membrane. Pre-operatively, air-bone gap of 30 db or more was observed in 39 (78%) patients whereas post-operatively A-B gap of 30 db or mare was observed in only one patient. Using hearings gain exceeding 15 dB as the criterion. 39 (78%) patients had their hearing gain exceeding 15 dB. Using post-operative A-B gap within 20 dB as the criterion. 42 (84%) patients had their A-8 gap within 20 dB. Myringoplasty is a beneficial procedure for hearing improvement. Using the proportion of patients with a post-operative A-B gap of 30 dB as the criterion, in this study. 98% of patients achieved their A-B gap closer within 30 dB. Using hearing gain exceeding 15 dB as the criterion, 78% patient had their hearing gain exceeding 15 dB.

Abstract Not Available Bangladesh J Otorhinolaryngol; April 2020; 26(1): 1-4

Synovial Sarcoma is a rare malignancy. It presents in adolescents and young adults. It occurs in soft tissue of extremities usually near to the large joints, heart, lung, mediastinum, head and neck. A 23-year-old female presented with a big hard fixed swelling in right supraclavicular region for 15 years. X-Ray chest posterior-anterior view presented Homogenous opacity in upper lobe of right lung. USG of neck showed large heterogeneous lobulated almost avascular solid mass in right side of root of neck and anterior upper mediastinum may be associated with Schwannoma/ paraganglioma/soft tissue sarcoma. Spindle cell lesion was reported by FNAC. MRI showed large slightly lobulated mass along right side of root of neck and right side of superior mediastinum. A large soft tissue density mass along right side of neck and superior mediastinum was found in CT scan. Surgical excision was done successfully. Histopathological examination revealed spindle cell tumor favoring synovial sarcoma in the neck tissue and metastatic spindle cell tumor in the lung lesion.