77 patients (56%) were readmitted to hospital, 66 (86%) for clearly alcohol-related reasons. 13 more patients re-attended the AandE Department without readmission. 100 day readmission rate was 50%. 19 patients were readmitted twice and 23 patients >3 times. Readmission was independently associated with unemployment (p = 0.043), self-discharge after index admission (p = 0.011), relapse into drinking (p = 0.028), and (surprisingly) with having received a brief intervention regarding alcohol consumption during the index admission from a dedicated alcohol worker (n = 61, p = 0.009). Seven more patients had died by 21/05/13, 5 from liver disease. Conclusion Patients admitted to hospital with AUDs tend to be socially deprived, frequent hospital attenders with major physical and mental co-morbidity. They have high subsequent alcohol relapse and hospital readmission rates. Reduction of these is not achieved by interventions during the index admission and will require more pro-active measures post-discharge.

coordinated, and quality of life of patient and carer was poor. All post-pilot metrics reported significant improvements. Improved efficiency evidenced by reduction in unplanned hospital admissions, increase use of alternative community services, with use of shared care plans. 83% of these achieved their preferred place of care and death in contrast to nil pre pilot. Conclusion This pathway worked for ASLD and needs wider evaluation and consideration of similar approaches to other groups.

Purpose: To compare the result of mid-shaft fracture radius and ulna treated by small DCP and LCP. Methods: Prospective interventional study, done in the Department of Orthopaedic Surgery, 250 Bedded General Hospital, Tangail from January, 2017 to December, 2018. The study was carried out with sample size 30 patients of mid-shaft fracture of radius and ulna. Out of them 15 were treated by DCP and screws and 15 patients were treated by LCP and screws. Results: In this study mean age in group I was 32.63±9.42 and in group II was 37.54+7.12. Male patients were 17 and female were 13 in number. Motor vehicle accident was the commonest cause of fracture found in 60% in group-I and 73.33% in group-II. In group-I, out of 15 cases all cases (100%) united with mean time of 15.87 ± 3.89 weeks. In group-II, out of 15 cases all (100%) cases united with the mean time of 14.0 ± 2.27 weeks. There was no major complication in both groups. Regarding the final outcome, excellent results in group-I were achieved with 11 (73.33%) cases while in group-II with 12 (80.00%) cases. Satisfactory results were seen in 04 (26.67%) cases in group-I and 03 (20.00%) cases in group-II. Conclusion: On the statistical point of view there was no significant difference between dynamic compression plate group and locking compression plate group for the treatment of mid-shaft fracture radius and ulna. J Shaheed Suhrawardy Med Coll, December 2019, Vol.11(2); 106-109

Background: Acute appendicitis is one of the important causes of emergency surgeries. Diagnosis of acute appendicitis remains to be challenging with up to 30% negative exploration rates. In addition to careful clinical history and physical examination, we still need easily applicable, cheap and effective biomarker. Complete blood count is the primary investigation for any inflammatory condition. Total WBC count and neutrophil percentage are widely used biomarkers to diagnose acute appendicitis. Mean platelet volume (MPV) is an emerging biomarker that has been considered to be affected by inflammatory burden. MPV value is also estimated during complete blood count. This study may help to reveal the change of MPV in acute appendicitis. Study design: This was a prospective observational type of study. Study setting and period: The study was carried out in the Surgery In-patient Department of Dhaka Medical College Hospital, Dhaka from 15-11-2013 till 15-04-2014. Materials: A total of 150 patients of both sex aged 15-65 years who got admitted in the surgery department for acute appendicitis were selected. Pediatric patients (aged less than 14years), patients with co morbid illness like ischemic heart disease, inflammatory bowel disease, general peritonitis and the patients having lack of necessary investigations were excluded from the study. Methods: The variables like total WBC count, neutrophil percentage, platelet count and mean platelet volume (MPV) of all 150 selected patients were noted after admission by doing complete blood count and compared with normal value. The appendix samples obtained after surgery were sent for histopathological confirmation and reports were collected. Results: A total of 150 patients with the mean age of 25.72 (ranging 15-65) years were studied. Among them 93(62%) were male and 57(38%) were female. Mean MPV value was 11.7 ± 0.183 fL (p value 0.02). 122 patients have increased MPV value (81.33%). Among them 113 were eventually diagnosed as acute appendicitis. Negative exploration rate was 14%.Negative exploration was less among MPV raised patients (7.38%). Whereas negative exploration was more among normal MPV patients (21.42%).Total WBC count and neutriphil percentage are important biomarkers to diagnose acute appendicitis which is accepted. However this study revealed MPV value is an important biomarker in acute appendicitis also which is statistically significant and can reduce negative exploration. Conclusion: In this study mean platelet volume increases in acute appendicitis. MPV can be used as a biomarker in diagnosis of acute appendicitis. Journal of Surgical Sciences (2018) Vol. 22 (2) : 83-88

Background: Serum-Ascitic Albumin Gradient (SAAG) can identify ascites related to portal hypertension. Esophageal varix (EV) is another feature of portal hypertension in cirrhosis. This study was done to find out the relation between SAAG and esophageal varices.Materials and methods: It was a cross- sectional descriptive study of 50 cases of cirrhotic ascites. SAAG was measured and upper gastrointestinal endoscopy was done for esophageal varices.Results: Among 50 cases, mean SAAG value 1.77 (±0.45 SD). Esophageal varices were found in 43(86%) cases. All cases with SAAG value >2.0gm/dl had EV. A significant statistical association was found between level of SAAG and the presence of esophageal varices (p=0.01).Conclusion: In patients of cirrhosis, the level of SAAG has positive association with the esophageal varices. This finding may permit us to use SAAG as a preliminary parameter of esophageal varices (EV) especially where endoscopy facilities are not available.TAJ 2014; 27(2): 36-38