<h4>Introduction :</h4>
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Carcinoma of unknown primary (CUP) in the head and neck region remains...
<h4>Introduction :</h4>
<p>
Carcinoma of unknown primary (CUP) in the head and neck region remains a persistent and complex challenge for clinicians worldwide. Significant advances in diagnostic modalities such as cross-sectional imaging, molecular diagnostics, robotic surgery, and positron emission tomography (PET) have improved the ability to identify primary sites, especially within the oropharynx, notably HPV-related cancers.<sup>1,2</sup>
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<p>
With the rising incidence of HPV-associated oropharyngeal carcinomas, the proportion of CUP cases presenting with regional metastases and occult primaries is also increasing, emphasizing the need for updated management strategies.<sup>3</sup>
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<h4>Definition and Historical Background :</h4>
<p>
CUP is a heterogeneous disease characterized by metastatic cervical lymph nodes with no identifiable primary tumor despite thorough evaluation efforts.<sup>4</sup>
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<p>
In many cases, these were presumed to involve ?branchiogenic carcinoma? ? a controversial and largely unsupported concept, since many series failed to meet the classical criteria established by Hayes Martin.<sup>5</sup>
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<p>
It is now recognized that a significant portion of patients represent metastatic carcinoma from occult primaries, primarily within the oropharynx.<sup>6</sup>
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<h4>Background :</h4>
<p>
Large bladder stones can cause significant morbidity and typically requi...
<h4>Background :</h4>
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Large bladder stones can cause significant morbidity and typically require active intervention. Pneumatic lithotripsy using a perurethral nephroscope is a minimally invasive and cost-effective treatment option. This study aimed to evaluate the efficacy and safety of treating large bladder stones using a perurethral nephroscope combined with pneumatic lithotripsy.
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<h4>Methods :</h4>
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This cross-sectional study was conducted at Pabna Medical College Hospital and affiliated private hospitals from February 2020 to January 2025. Twenty-three patients with large bladder stones (≥3 cm) were enrolled.
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<p>
All patients underwent stone fragmentation using pneumatic lithotripsy with a perurethral nephroscope. Operative time, hospital stay, catheterization duration, and complications were documented. Data were analyzed using SPSS version 25.0, with significance set at p<0.05.
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<h4>Results :</h4>
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The mean age was 52 ? 12 years, and 87.0% of the patients were male. The average stone size was 4.1 ? 0.6 cm in diameter.
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The mean operative time was 48.5 ? 12.0 minutes, with an average hospital stay of 1.6 ? 0.5 days. All patients were stone-free after the procedure.
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<p>
Minor complications occurred in 26.1% of cases, including hematuria (13.0%), urinary retention (8.7%), and fever or stricture (4.3% each). No major complications were noted.
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<h4>Conclusion :</h4>
<p>
Perurethral nephroscopy with pneumatic lithotripsy is an effective, safe, and minimally invasive technique for managing large bladder stones, particularly in resource-limited settings.
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<h4>Background :</h4>
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Minimally invasive approaches are a more recent development aimed at red...
<h4>Background :</h4>
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Minimally invasive approaches are a more recent development aimed at reducing damage to soft tissues. The subvastus or Southern approach to the knee was described as early as 1929. This approach for primary total knee arthroplasty (TKA) preserves the integrity of the extensor mechanism and maintains the vascular supply to the patella.
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It provides excellent exposure of the knee joint with preservation of all peri-articular soft tissues. The benefits of the subvastus approach make it a valuable technique for primary TKA. This combination of advantages ensures rapid recovery, better knee range of motion, and excellent patient satisfaction.
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<h4>Aim of the Study :</h4>
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The goal of this study was to compare the subvastus method with the usual medial parapatellar technique for total knee replacement in patients with osteoarthritis based on quadriceps function recovery in the days following surgery.
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<h4>Methods :</h4>
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We retrospectively reviewed case notes of 36 patients with osteoarthritis who underwent total knee replacement in Satkhira Medical College Hospital and private clinics over a period from August 2019 to August 2024.
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All cases were evaluated regarding early post-surgical clinical outcomes including range of motion (ROM), pain on a visual analog scale, and Knee Society Score (KSS). Preoperative quadriceps strength, BMI, and baseline demographics were recorded from pre-operative workup case notes.
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<p>
Starting from the first postoperative day, the first unassisted straight leg raise (SLR) was recorded as the main determinant of muscle function. The data were evaluated to determine quadriceps muscle function following total knee replacement.
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<h4>Result :</h4>
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When compared to the medial parapatellar approach, quadriceps muscle function returned sooner with the subvastus technique. Patients in their sixties showed the highest improvement.
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Preoperative quadriceps strength had a major impact on muscle recovery after surgery.
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<h4>Conclusion :</h4>
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The subvastus method for total knee replacement is associated with faster recovery of quadriceps muscle strength, resulting in shorter hospital stay and reduced postoperative therapy.
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<h4>Background :</h4>
<p>
Laparoscopic cholecystectomy (LC) is the standard treatment for symptoma...
<h4>Background :</h4>
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Laparoscopic cholecystectomy (LC) is the standard treatment for symptomatic gallstones. The initial abdominal entry, which is critical to safety, employs either blind trocar entry (BTE) or the Hasson method. This study compares these techniques in 100 patients.
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<h4>Methods :</h4>
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A single-center randomized controlled trial allocated 100 patients to BTE (n=50) or Hasson (n=50). Outcomes included operative time, complications (visceral/vascular injury, extraperitoneal insufflation), conversion rates, and hospital stay. Statistical analysis was performed using t-tests and chi-square tests.
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<h4>Results :</h4>
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The Hasson method had a longer mean operative time (47.5 ? 8.2 vs. 42.3 ? 6.5 minutes; p=0.001) but fewer major complications.
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Visceral injury was 0% in the Hasson group versus 4% in the BTE group (p=0.04), and vascular injury was 0% in the Hasson group versus 2% in the BTE group (p=0.32).
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<p>
BTE had higher visceral injury rates (4% vs. 0%, p=0.04). Hospital stay and conversion rates were comparable between the two groups.
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<h4>Conclusion :</h4>
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The Hasson method reduces complications during laparoscopic cholecystectomy compared with blind trocar entry while maintaining comparable hospital stay and conversion rates.
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<h4>Background :</h4>
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Hemorrhoids are important today due to rising sedentary lifestyles, poor...
<h4>Background :</h4>
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Hemorrhoids are important today due to rising sedentary lifestyles, poor diets, and stress, leading to increased cases, healthcare costs, and demand for awareness and effective treatments.
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<h4>Objective :</h4>
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The study aimed to analyze the success of rubber band ligation in grade I, II, and III hemorrhoids, to evaluate associated complications, and to determine whether all symptomatic hemorrhoids should be treated with band ligation at the first visit.
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<h4>Methods :</h4>
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A prospective and descriptive study was designed for patients who attended the OPD of Chittagong Medical College Hospital from July 2007 to June 2008. Patients having large 1st degree hemorrhoids, 2nd degree, and early 3rd degree hemorrhoids were treated.
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<h4>Results :</h4>
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Rectal bleeding was the most common symptom (100%). Anoscopy showed 6% first degree, 86% second degree, and 8% third degree hemorrhoids.
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Information on presenting symptoms, number of bands applied, response to therapy, complications encountered, number of sessions needed to improve symptoms, requirement of analgesics, follow-up of patients, and subsequent therapy were documented. Supplementary information was obtained through telephone follow-up.
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Outcome was categorized as success or failure. Success was defined as permanent relief of symptoms during follow-up periods. Improvement in symptomatology was defined as rare manifestation of bleeding (< 1 month). Failure was defined as decrease but no improvement of symptoms.
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In this study, 88% of patients succeeded, 6% improved, and 6% failed. 16% of patients had bleeding during defecation for < 7 days, while 8% complained of bleeding for > 7 days. Recurrence was observed in 2% of patients.
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38% of patients required no analgesics. Among the 62% who required analgesics, 36.8% required them for up to 24 hours, 47.37% required them for 24?48 hours, and 3 patients required them for > 48 hours.
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All patients attended the first follow-up on the 7th day, 14% missed the second follow-up at 6 weeks, and 16% missed the third follow-up at 6 months.
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<h4>Conclusion :</h4>
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Rubber band ligation is a quick and simple procedure requiring no anesthesia in the absence of anorectal pathologies other than hemorrhoids. Though it has some minor complications and a chance of recurrence, it is considered a safe and effective procedure for symptomatic hemorrhoids.
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<h4>Keywords :</h4>
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Rubber Band Ligation, Hemorrhoids.
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<h4>Introduction :</h4>
<p>
Cancer is a deadly name for resource-constrained developing countries...
<h4>Introduction :</h4>
<p>
Cancer is a deadly name for resource-constrained developing countries like Bangladesh. It is not just a killer; it tells many human stories, comprising fear, cry, depression, financial crisis, love, care, deep sorrow and happy moments of cure.
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<p>
Cancer is the first or second leading cause of premature death (i.e. at ages 30?69 years) in 134 of 183 countries, and it ranks third or fourth in an additional 45 countries.<sup>1</sup>
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Globally in 2020, every 6 deaths included 1 cancer patient and the number of deaths due to cancer was 10 million. It may increase to 15 million by the next decade. Two-thirds of cancer-related deaths occur in developing countries.<sup>2</sup>
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In Bangladesh, 114 persons per lac suffer from various cancers. In unpublished data from Bangladesh, about 55 persons per lac are affected by Head-Neck Cancer. Approximately 20 lacs cancer patients are in Bangladesh.
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Newly affected are 53 persons per lac. About 2 lacs are affected every year and around 1 lac dies of cancer every year. In this country, 12% of deaths are due to cancer. Daily deaths are about 273 in Bangladesh. According to studies, there is a definite risk of this number doubling over the next three decades.<sup>3</sup>
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