<h4>Introduction :</h4>
<p>
About 68% of the general population have thyroid nodules on routine ul...
<h4>Introduction :</h4>
<p>
About 68% of the general population have thyroid nodules on routine ultrasonography. That does not mean all nodules should be treated by surgery, as most nodules are benign and discovered incidentally. Therefore, the primary goal of thyroid nodule evaluation is to determine whether the nodule is malignant.
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<p>
After thyroid ultrasonography has been performed, the next step is measurement of serum thyroid-stimulating hormone. Hyperfunctioning nodules are rarely malignant and do not require tissue sampling.
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<p>
Nonfunctioning nodules and nodules in patients with normal or high thyroid-stimulating hormone levels may require fine-needle aspiration based on ultrasound characteristics and size. Nodules with suspicious features and solid hypoechoic nodules 1 cm or larger require aspiration.
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<p>
The Bethesda System (categories I through VI) is used for classification. Benign nodules (Bethesda II) do not require surgery and should be followed up with regular physical examination and ultrasonography to monitor progression of the nodules, such as increase in size or suspicious changes, usually at one-year intervals.
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<p>
As surgery is not without risk, unnecessary surgical intervention may lead to recurrent and superior laryngeal nerve damage, voice loss, parathyroid insufficiency, neck scarring, and lifelong thyroid hormone replacement.
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<p>
In the UK, there is variation in monitoring thyroid nodules. Some hospital clinics discharge patients once cancer has been excluded, whereas other hospitals monitor nodules with repeat ultrasonography.
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<p>
In Ireland, including our hospital, benign nodules are monitored with repeat ultrasonography at one-year intervals, a practice known as surveillance ultrasonography.
</p>
<h4>Introduction :</h4>
<p>
Anaesthesia management plays a critical role in ensuring patient safet...
<h4>Introduction :</h4>
<p>
Anaesthesia management plays a critical role in ensuring patient safety and comfort during and after surgical procedures. The choice of anaesthesia type?whether regional or general?can significantly influence the incidence of complications and overall patient recovery. This study aimed to evaluate anaesthesia practices, monitor complications, and assess patient satisfaction among individuals undergoing various types of surgery.
</p>
<h4>Methods :</h4>
<p>
The study was conducted at General Hospital, Pabna, Bangladesh from 1st October 2023 to 30th September 2024. Data were collected from medical records of patients who underwent surgery at the hospital. The study population consisted of 42 individuals, with a higher proportion of females and the largest age group being 18?40 years.
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<p>
Data analysis was performed using SPSS version 26.
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<h4>Result :</h4>
<p>
The results of this study indicate that 57.1% of patients received regional anaesthesia, while 42.9% were administered general anaesthesia. Monitoring techniques, including pulse oximetry, ECG, and blood pressure, were widely used, with complications occurring in 33.3% of the population.
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<p>
Post-anaesthesia complications were most commonly nausea (42.9%) and hypotension (4.8%). Patient satisfaction was high, with 95.2% reporting satisfaction.
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<p>
A significant negative correlation (-0.361, p=0.0188) was found between general anaesthesia and the absence of complications.
</p>
<h4>Conclusion :</h4>
<p>
The findings indicate that regional anaesthesia is associated with fewer post-anaesthesia complications compared to general anaesthesia. The statistically significant p-value (p<0.05) underscores a meaningful association between the type of anaesthesia and the occurrence of post-anaesthesia complications.
</p>
<h4>Background :</h4>
<p>
Split-thickness skin grafting (STSG) is a cornerstone in reconstructive...
<h4>Background :</h4>
<p>
Split-thickness skin grafting (STSG) is a cornerstone in reconstructive surgery. The Humby knife and shaving blade are two techniques for harvesting grafts, but their comparative efficacy remains understudied. This trial evaluates outcomes of both methods in 100 patients.
</p>
<h4>Methods :</h4>
<p>
A single-center randomized controlled trial (2021?2023) was conducted on 100 patients divided into 2 groups: Humby knife (n=50) and shaving blade (n=50).
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<p>
Primary outcomes included graft take rate and complications. Secondary outcomes were operative time, pain scores, and cosmetic results. Statistical analysis was performed using t-tests, chi-square, and multivariate regression.
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<h4>Results :</h4>
<p>
The Humby knife group had higher graft take rates (94% vs. 82%, p=0.03), lower infection rates (4% vs. 14%, p=0.04), and superior cosmetic outcomes (Humby: 6% vs. Shaving: 18%, p=0.03).
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<p>
Operative time was longer for the Humby knife group (28.5 ? 4.1 vs. 18.2 ? 3.8 minutes, p<0.001).
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<h4>Conclusion :</h4>
<p>
The Humby knife offers superior graft survival and cosmetic outcomes despite longer operative time, supporting its use in critical reconstructive cases.
</p>
<h4>Background :</h4>
<p>
Distal radius fractures are common, with volar Barton fractures posing a...
<h4>Background :</h4>
<p>
Distal radius fractures are common, with volar Barton fractures posing a unique challenge due to their intra-articular nature and instability. These injuries often result from high-energy trauma and involve dislocation of the radiocarpal joint.
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<p>
Conservative treatment frequently yields poor outcomes, prompting a shift toward surgical management. Volar buttress plating via open reduction and internal fixation (ORIF) has emerged as the preferred approach, offering stable fixation, early mobilization, and favorable functional recovery.
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<p>
Anatomically contoured low-profile plates enhance outcomes by minimizing soft tissue complications. Despite some risks, such as tendon irritation, clinical results have generally been positive when appropriate surgical protocols are followed.
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<h4>Aim of the Study :</h4>
<p>
This study aims to evaluate the treatment outcomes of volar Barton fractures of the distal radius managed with volar buttress plates.
</p>
<h4>Methods :</h4>
<p>
This prospective observational study was conducted over 12 months, from July 2023 to June 2024, at the Department of Orthopaedics of Pabna Medical College, Bangladesh, to evaluate outcomes of volar Barton fractures treated with open reduction and internal fixation using a volar buttress plate.
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<p>
Thirty (30) adult patients with closed, radiologically confirmed volar Barton fractures were included. The surgery involved a standard volar (Henry?s) approach with fixation using locking or non-locking screws.
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<p>
Postoperative care included early mobilization and radiographic follow-up at 2, 6, and 12 weeks postoperatively. Outcomes were assessed radiologically and functionally using the Mayo Wrist Score. Data were analyzed descriptively using SPSS version 26.0 without inferential statistics.
</p>
<h4>Results :</h4>
<p>
In this study of 30 patients with volar Barton fractures treated using buttress plate fixation, most were males (70%) aged 30?50 years (53.33%), with the right hand predominantly affected (93.33%).
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<p>
The primary cause was falls on an outstretched hand (56.67%). Radiographic union occurred within 6?12 weeks in 70% of cases, and final alignment was maintained in 90% of cases.
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<p>
Functional assessment using the Mayo Wrist Score showed excellent to good outcomes in 86.67% of patients.
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<p>
Complications were minimal, including superficial infection (3.33%), tendon irritation (3.33%), and implant prominence (6.67%). No cases of deep infection, implant failure, or reduction loss were reported.
</p>
<h4>Conclusion :</h4>
<p>
Volar buttress plate fixation is an effective treatment for volar Barton fractures, promoting early union, stable anatomical reduction, and good functional recovery with minimal complications.
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<p>
Optimal outcomes depend on selecting appropriate patients, performing surgery promptly, and employing precise surgical techniques.
</p>
<h4>Background :</h4>
<p>
Primary hyperparathyroidism is a frequent endocrine disorder with variab...
<h4>Background :</h4>
<p>
Primary hyperparathyroidism is a frequent endocrine disorder with variable clinical manifestation and outcome. This study aimed to evaluate the impact of parathyroidectomy on quality of life and symptom relief in patients with primary hyperparathyroidism.
</p>
<h4>Materials and Methods :</h4>
<p>
A cross-sectional study was conducted in the Head and Neck Surgery Division of the Department of Otolaryngology?Head & Neck Surgery, BSMMU, Shahbag, Dhaka from August 2022 to January 2023. A total of 25 patients underwent parathyroidectomy.
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<p>
Parathyroid function was measured by parathyroid hormone (PTH) level. Baseline levels of PTH and total calcium (Ca) were evaluated preoperatively, and postoperative levels were measured before skin incision, 10 minutes after parathyroidectomy, 24 hours later, and on day 7 accordingly.
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<p>
The data were calculated in an Excel spreadsheet and then exported to SPSS 26.0 (Statistical Package for the Social Sciences) for analysis. Statistical significance was set at p<0.05.
</p>
<h4>Results :</h4>
<p>
In this series, 3 (8.5%), 6 (17.1%), and 2 (5.7%) patients presented with osteitis fibrosa cystica, nephrolithiasis, and neuropsychiatric syndrome respectively.
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<p>
Moreover, 14 (40.0%) patients had muscle weakness, and 18 (51.0%) subjects presented with fatigue. It was observed that preoperative PTH and calcium levels and postoperative calcium levels in SPHPT and ASPHPT were statistically significant.
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<p>
A notable improvement in health-related quality of life was observed, with the VAS score rising from 70 (IQR: 50?80) to 80 (IQR: 70?90).
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<h4>Conclusion :</h4>
<p>
This study provides evidence supporting the enduring advantages of parathyroidectomy in individuals with primary hyperparathyroidism (PHPT). The observed reduction in pre-operative symptoms appears to be a significant factor contributing to the enhanced quality of life (QOL) experienced by these patients over the long term.
</p>
<h4>Background :</h4>
<p>
Appendicular abscesses are a common complication of acute appendicitis,...
<h4>Background :</h4>
<p>
Appendicular abscesses are a common complication of acute appendicitis, often requiring surgical drainage. The optimal method of skin closure after drainage remains debated. This study compares primary skin closure (PC) and delayed skin closure (DC) in terms of surgical site infection (SSI), hospital stay, wound healing time, and patient satisfaction.
</p>
<h4>Methods :</h4>
<p>
A single-blind randomized controlled trial was conducted on 200 patients with appendicular abscesses confirmed via ultrasound or CT scan. Patients were randomized to PC (immediate closure) or DC (closure after 48 hours of open packing).
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<p>
Outcomes included SSI rates (CDC criteria), hospitalization duration, time to complete healing, and patient-reported outcomes.
</p>
<h4>Results :</h4>
<p>
The DC group had significantly lower SSI rates (8% vs. 18%, p=0.02) but longer hospital stays (5.8 vs. 3.2 days, p<0.001) and healing times (14.5 vs. 10.2 days, p=0.01).
</p>
<p>
Diabetic patients in the PC group had a 30% SSI rate compared to 12% in the DC group (p=0.04). Patient satisfaction was higher in the PC group due to faster recovery.
</p>
<h4>Conclusion :</h4>
<p>
Delayed closure reduces SSI risk, particularly in high-risk populations, but prolongs recovery. Primary closure is advantageous in low-resource settings or for patients prioritizing shorter hospitalization.
</p>
