Introduction: Otitis media with effusion (OME) is an inflammatory disorder of the middle ear that is characterised by the presence of endotympanic fluid without any sign or symptom of acute ear infection which may lead to hearing loss (HL) or long-term sequelae and have a negative impact on speech development and behavior. It is the prime cause of impaired hearing and social trouble in children which has long term impact on speech and language development. Enlarged Adenoid is a very common causative factor in the development of OME. Objective: To observe the hearing improvement after adenoidectomy alone in children with otitis media with effusion. Methods: This is a prospective descriptive study had been carried out in Dept. of ENT, Abdul Malek Ukil Medical College Hospital, Noakhali, Bangladesh from January to December-2020. A total 45 patients aged 3 to 12 years old who had adenoid hypertrophy and OME, confirmed with pre-operative X-ray nasopharynx lateral view, PTA and tympanometry were included in this study. All patients underwent adenoidectomy under General anaesthesia. Follow up was done with PTA and tympanometry at 3rd months after operation. Result: Among 90 ears of 45 patients, pre-operative tympanometry showed type B curve in 53.33% of ears. Post-operative audiometric assessment showed mean hearing gain at 3rd month being 5.32 dB. At 3rd month follow up, 22 ears had type A curve, only 8 ears had type B curve and 60 ears had type C curve. Conclusion: So, adenoidectomy is an effective operation in correcting middle ear effusion and resulting hearing improvement as well as speech and language development in children with enlarged adenoid and OME.

Introduction: Atrial septal defect is one of the congenital heart diseases. An atrial septal defect (ASD) represents a communication between the left and right atrium leading to left to right shunt. It makes up about 10% of all congenital heart diseases after delivery and up to 30—40% of heart defects diagnosed in patients aged over 40 years. Objectives: To identify the status of cardiac remodeling after surgical patch closure of adult congenital atrial septal defects. Methodology: The descriptive and observation study was carried out atDepartment of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2013 to April 2015. The patients both male and female undergoing surgical closure of atrial septal defect, Department of Cardiac Surgery, BSMMU, Dhaka, Bangladesh. Total sixty (60) patients were studied, thirty (30) in each group. Group A: Thirty (30) patients of surgical closure of ASD at or before age of 25 years. Group B: Thirty (30) patients of surgical closure of ASD at or after age of 25 years. A purposive sampling technique was used for sample selection. The sample size was determined by using the standard formula for comparison between two proportions. To make it more convenient and reduce the error sample size of this study was fixed at 60 (30 in each group). Careful history regarding the complaints of Exerttional dyspnoea, Palpitation, Fatigability, General weakness, Electrocardiography (ECG), Chest X ray, Echocardiography (Echo), Left atrial diameter (LA), -Left ventricular internal diameter at the end of diaslole (LVIDd), -Left ventricular internal diameter at the end of systole (LVIDs), Interventricular septal thickness (IVST), Posterior wall thickness (PWT), Fractional shortening (FS), Ejection fraction (EF) were measured. Results: From the result it was found that exertional dyspnoea in 60.0%, palpitation in 70.0%, fatigue in 66.6% and general weakness in 53.33% in group A and in group B exertional dyspnoea in 80.0%, palpitation in 73.33%, fatigability in 63.33% and general weakness in 80.0%. There was no significant difference in presenting complaints distribution in between two groups. From the ECG findings between two study groups it was found that arrhythmia in 13.33%, left axis deviation in 10.0%, right axis deviation 23.330% and in group B arrhythmia in 16.67%, left axis deviation in 13.33%, right axis deviation 36.67%. There were differences between two groups regarding ECG findings. In early age group there was few complains but complains are more in late age group. From the types of ASD between two study groups it was revealed that septum secundum defect is 66.67%, Septum primum 20 % and sinous venosus defect in 13.33 % in group A. In group B septum secundum defect is 76.67%, Septum primum 13.33 % and sinous venosus defect in 10 %. There was no significant difference in type of ASD in between two groups. Conclusion: This study concluded that cardiac remodeling occurs after surgical closure of atrial septal defect in all age group and degree of cardiac remodeling was better in early age group (up to 25 years) compared with late age group (>25 years).

Background: Alopecia areata is a common problem faced by many younger people, which has variety of risk factors. Vitamin D has emerged as a molecule with key role to play in various disorders. Recent evidences suggest inconsistent association between vitamin D deficiency and alopecia areata. We have very few research-oriented data regarding this issue. Aim of the study: The aim of this study was to assess the status of serum Vitamin-D level among the patients with alopecia areata. Methods: This was a prospective case control study which was conducted in the Department of Dermatology & Venereology, Anwer Khan Modern Medical College, Dhaka, Bangladesh during the period from January 2018 to December 2019. In total 30 patients with alopecia areata and 30 healthy people were finalized as the study population. Group of 30 alopecia areata (AA) was denoted as Group A (Case) and group of healthy people was denoted as Group B (Control). All patients were subjected to detailed history taking and examination to detect pattern, severity (SALT score) of AA. Blood samples were taken from all subjects to do complete blood count and to assess serum levels of vitamin-D3, random blood sugar, and calcium. All data were processed, analyzed and disseminated by MS Office and SPSS version 20 as per need. Results: The mean (±SD) vitamin level was found 8.63 ± 2.24 ng/mL among case group patients. On the other hand, it was found 30.26 ± 7.81 ng/mL among control group participants which was significantly higher than that of case group patients (P<0.0001). In analyzing the comparative status of Vitamin D level of several SALT score patients with control group we observed, in comparison with all the S1 patients, S2 patients, S3 patients and S4 patients the P values were found less than 0.0001. So, among all the above cases groups patients the level of vitamin D(ng/mL) were extremely significantly lower than that of control participants (In all comparison the P value were less than 0.0001). Besides among S5 patients, vitamin D level was also significantly lower than that of control group participants where P value was found 0.0002. Conclusion: Deficiency of vitamin D level is a potential factor of alopecia areata. Lower vitamin D levels were observed in patients with alopecia areata and significant inverse correlation exists between vitamin D levels and duration/severity of the disease. These findings may suggest a causal role of vitamin D deficiency in the pathogenesis and therapeutic role of vitamin D supplementation in the management of alopecia areata.

Introduction: Gestational diabetes mellitus (GDM) is a transitory form of diabetes (glucose intolerance) with onset or first recognition during pregnancy. It is a major and growing public health problem in most parts of the world, with a global prevalence of between 2% and 6% (and as high as 20% in high-risk populations). Gestational Diabetes Mellitus (GDM) is a metabolic disorder defined as glucose intolerance with onset or first recognition during pregnancy. These women are at increased risk of adverse maternal and fetal outcome. Therefore, it’s early diagnosis and management is essential for better fetomaternal outcome. Objective: To assess the prevalence, risk factors and its outcome of gestational diabetes mellitus. Materials and Methods: A Prospective hospital based study was carried out at Dept. of Obstetrics & Gynecology, Al Hera Hospital (Private Clinic), Mawna Chowrasta, Sreepur, Gazipur, Bangladesh from June to December 2021. They were given 75gm glucose irrespective of meals and after 2 hours plasma glucose was estimated. GDM was diagnosed when after 2hours plasma glucose was>140mg/dl. All patients with GDM were followed up and treated with diet and /or insulin therapy till delivery. Maternal and fetal risks factors and outcome were evaluated. Results: Prevalence of GDM was 8.2% in my study. Many of the cases diagnosed as GDM had previous history of large baby, still birth or spontaneous abortion. Maternal complications observed were PIH (40%), polyhydramnious (37.7%), while 66.6% had to undergo caesarean section. Preterm labour occurred in 4 case each (8.8%). No complications were observed in 8 cases (17.7%). 28.8% babies had birth weight of >3.5kg and 17.7% were below 2.5 kg. Conclusion: Women with GDM showed an increased risk of obstetrical and fetal complications. Estimation of plasma glucose level using DIPSI criteria is a single step and cost -effective test to screen large number of cases and to diagnose and manage GDM to prevent maternal and fetal complications.

Epidermal inclusion cysts are the most common cutaneous cysts. Numerous synonyms for epidermal inclusion cysts exist, including epidermoid cyst, epidermal cyst, infundibular cyst, inclusion cyst, and keratin cyst. These cysts typically present as nodules directly underneath the patient's skin, and often have a visible central punctum. They are usually freely moveable. The size of these cysts can range from a few millimeters to several centimeters in diameter. Though can occur anywhere in the body, cysts in retrorectal or coccygeal region is quite rare, particularly in adults. Here we present a case of large coccygeal epidermoid inclusion cyst in an elderly lady.

Background: Perianal fistulas can present significant morbidity and detriment to a patient’s quality of life. Perianal fistula is among the most common anorectal diseases encountered in adults, men are more prone to be affected than women. Objective: To determine the incidence of fistula After Management of Perianal Abscess. Materials and Methods: A retrospective study of 34 patients with perianal abscess operations conducted in Dept. of Surgery, Sheikh Hasina Medical College and Hospital, Tangail, Bangladesh from January 2017 to December 2021. Their ages ranged from 20 to 68 years (40.21 ± 1.34) males (31/34) (92.64%) were more than females (3/34) (7.35%). Patients were treated with incision over the abscess under anesthesia and drainage of the abscess was done. The patients were followed up for an average 18 months (range 12–24 months) after abscess drainage or until a fistula appeared and abscess recurrence. Results: The study group comprised of 34 (92.64%) patients with perianal abscess with a median age 39 years (range 20–68 years). The mean follow-up period was identified to be 18 months (range 12–24 months). Males (31/34) (92.64%) were more than females (3/34) (7.35%). The incidence of fistula formation after follow up, the patients with perianal abscess after incision and drainage was 16/34 (47.07%) and males (15/16) (44.11%) were more than females (1/16) (2.94%). The most common site was posterior then left lateral position. The percentage of patients with recurrent abscess n = 3 (8.82%) were lower than fistula formation n =16 (47.07%). The percentage of males n = 2/3 (5.88%) were more than females 1/3 (2.94%). Conclusions: The incidence of anal fistula in a sample of Bangladeshi patients with perianal abscess was 47.05% and percentage of recurrence of perianal abscess was 8.82%. To avoid division of anal sphincter muscle, secondary fistulotomy is advised to be done later when anal fistula will be formed.