Introduction: Premature rupture of membrane or PROM means when membrane ruptures before the onset of labour at a gestational age less than 37 completed weeks. In Bangladesh, every year, around 28,000 women die due to complications of pregnancy and childbirth. Nonscientific intervention in PROM made at various levels intensify the pregnancy complications several times, thereby leading many more deaths of foetus and newborn. Aetiology of PROM is largely unknown. The possible causes are either reduction of membrane strength or an increase in intrauterine pressure or both. Proper diagnostic facilities, proper monitoring and standard protocol in the management can improve the maternal and fetal outcome.Aim and objective: The aim of the study was to observe the incidence, type and maternal and fetal outcome of PROM.Materials and Method: A prospective case control analytical study was carried out at Dhaka Medical College Hospital, Dhaka from May ‘2000 to December‘2000. Total 120 patients were selected for this study among them 60 patients as case (Group A) and 60 patients were taken as control (Group B). Both primi and multigravida with Pregnancy more than 28 weeks with intact membrane as control and spontaneous rupture of membrane taken as case. High- risk patients such as hypertensive disorder of pregnancy, APH, cardiac disease, previous H/O caesarean section were excluded from the study. After taking proper history, speculum examination, some diagnostic investigations were carried out. Findings were recorded in predesigned questionnaire and statistical analysis were done using computerized software SPSS for Windows. A P value < 0.05 was taken as significant.Results: In our study maternal complications were significantly higher in Group A patients (Chi-square test: X2 = 6.263, df= 1, P< 0.05). Number of premature babies in PROM patients (25%) was significantly higher than control group. Perinatal morbidity was found higher in PROM (36.66%) compared to control group (31.66%). Most common morbidity was neonatal jaundice in PROM patients (13.33%) compared to babies of control group (8.33%).Conclusion: This study focused on certain risk factors in relation to PROM which can be preventable and reduce incidence and improvement of maternal and fetal outcome.J Dhaka Medical College, Vol. 25, No.2, October, 2016, Page 82-86

Abstract:Traditional practice of postoperative starvation after abdominal surgery recently has been changed. Early enteral feeding has been shown benefits in reduction of postoperative ileus and hospital stay by various clinical trials. In this study postoperative outcome was analized after colostomy closure in paediatric patients in relation to early vursus traditional enteral feeding. This is a prospective comparative study done in Dhaka Shishu (children) Hospital between January 2009 to December 2013. Total 125 patients were included and divided into two groups. Group-A (n=55) and Group-B (n=70) underwent traditional enteral feeding and early enteral feeding in post-operative period respectively. Unpaired 't' test were used for statistical analysis. Post-operative hospital stay and complications such as vomiting, diarrhoea, wound disruption were assessed. Lower gastro-intestinal bleeding, urinary tract infection (UTI), upper respiratory tract infection (URTI) and unspecified fever >48 hours were used as parameters of study. In group-B, post-operative hospital stay and complications such as vomiting, diarrhoea, wound disruption, lower G.I bleeding, UTI, URTI and unspecified fever >48 hours were significantly lesser than group-A. Parents were satisfied with early enteral feeding in post-operative period. By this study early enteral feeding patients found to be more advantageous than the traditional feeding patients undergoing colostomy closure.

Introduction : when a healthy pregnant woman with no obstetric or medical risk factors goes into spontaneous labour, she should anticipate a normal delivery. But still 580, 000 women in the world die from pregnancy and childbirth each year.1 Lack of attention to postpartum care in developing countries is neglected tragedy and requires immediate attention. This study evaluates the incidence of complications of early puerperium and also focuses the specific types of complications and to detect the risk factors associated with these complications. Aims and objectives : Main aim of the study is to evaluate the common complications in early puerperium with special attention to identify the risk factors. Materials and method : This study was carried out in Dhaka Medical College Hospital and Sir Sallimullah Medical College Hospital within the period of March ’2004 to August’ 2004. Two hundred patients were selected for this study who were delivered by caesarean section in these two institutions and complications occurring within 7 days excluding first 24 hours. Patients delivered outside the hospital and with known medical diseases were excluded from this study. Detailed history taking and appropriate clinical examination and specific investigations were done for diagnosis of complications. All relevant informations was noted in prescribed data sheet and results were tabulated and statistical analysis was done. Results : Among 200 cases only 44(22%) cases had early puerperal morbidity.Most of the patients who suffered complications underwent caesarean section for obstructed labour and fetal distress who had trial at home. Many of the patients suffered from wound infection and endometritis (40.9%). Among patients, age group -<20 years suffered from wound infection(53.8%) and endometritis(45.8%) were common in age group 21-30 years. VVF was common in patients in age <20 years.Endometritis (42.2%) was maximum in women with parity 1-3 and wound infection (50%) in women with parity 4-6. Some of the patients had more than one early puerperal morbidity. Maximum number of poor class suffered from wound infection (42.4%).Early puerperal morbidity was more prevalent in women with duration of labour <18 hours and Premature rupture of membrane had relationship with endometritis (15.9%), wound infection (13.6%) and UTI (11.4%). Conclusion : Incidence of early puerperal morbidities is still quite high (22%) and many patients experiences more than one problem at a time.Long term sequelae of early puerperal infectious morbidity should not be neglected as this may interfere quality of life of a woman. J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 68-71

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We report a rare case of c-kit negative gastrointestinal stromal tumor with metastasis in left cervical lymph nodes and subcutaneous tissue. The patient presented to us with recurrent neck swelling, perforation of gas containing hollow viscous and multiple subcutaneous swellings. After confirmation of diagnosis we transferred the patient to medical oncologist. Patient expired two months after starting chemotherapy. Journal of Surgical Sciences (2017) Vol. 21 (2): 115-117