I perform all sorts of general pediatric surgery including neonatal surgery. Also perform pediatric urology, plastic surgery and neurosurgery. Have special interest in laparoscopic/endoscopic surgeries in children and is the pioneer in this field in Bangladesh. Have a vision to establish Pediatric Endosurgery as a specialty among pediatric surgeons and physicians of Bangladesh. Editor-in-Chief: Bangladesh Journal of Endosurgery. Phone: +8801819345305 Address: Chattogram, Bangladesh
Background Laparoscopy can identify patients who would benefit from further surgical interventio... more Background Laparoscopy can identify patients who would benefit from further surgical intervention. Most importantly it is 100% sensitive in identifying the vanishing testicle. Aims To review the role of laparoscopy in the management of the undescended testis. Methods Thirty-one patients underwent a laparoscopy for an impalpable testicle over a nine-year period at this institution. Results There were 30 successful laparoscopies completed for 31 impalpable
Background Owing to the widespread use of general anesthesia, administration of spinal anesthesia... more Background Owing to the widespread use of general anesthesia, administration of spinal anesthesia in pediatric patients is not widely practiced. Yet there is ample positive evidence demonstrating its safety, effectiveness, and success. Objective The objective of this study is to compare postoperative patient comfort, length of hospital stay, and cost-effectiveness of pediatric laparoscopic appendectomies performed under spinal and general anesthesia with the usual standard-of-care procedures employed in the hospital. Methods This is a case series of 77 consecutive pediatric laparoscopic appendectomies (involving 5-8–year-old children) that took place in a hospital in Chittagong, Bangladesh, in 2019. A total of 40 patients underwent spinal anesthesia and 37 patients underwent general anesthesia. Variables such as surgery and operation theater times, pain score, incidence of postsurgery vomiting, analgesic usage, discharge times, and hospital costs were recorded. Statistical analysis ...
Background: COVID-19 has highly impacted the education system and has created trends in online cl... more Background: COVID-19 has highly impacted the education system and has created trends in online classes. To fill in the gap created by lockdown and to continue the uninterrupted learning process, educational institutions worldwide started organizing online classes. Although medical education is mostly practical, it is not safe to conduct on campus classes. This study aimed to measure the scope and limitations of online education and the overall impact of COVID-19 on the medical education system.Methodology: This was a cross-sectional study. Ethical approval was obtained from the ethical committee of the South Point Hospital. Informed consent was obtained. Self-administered questionnaires were administered to participants.Results: E-Learning opportunities were made available in 98.69% of cases; some student forums also participated. Among survey respondents, females predominated (57.39%), and 42% of respondents belonged to rural areas and small towns. Access and quality of internet du...
Purpose: There are numerous procedures of minimally invasive surgery for repair of inguinal herni... more Purpose: There are numerous procedures of minimally invasive surgery for repair of inguinal hernia in children including percutaneous techniques. We describe here our technique of using 18G or 20G needle in a very simple and effective way for this purpose. Methods: Needle-assisted laparoscopic percutaneous repair internal ring was performed in 55 children between 1st November 2010 and 31st July 2011. An 18G or 20G needle and a 3/0 polyglycolic acid thread were used. A 5-mm supraumbilical port for 30 5 mm telescope and a 3-mm port in iliac fossa opposite to the lesion to handle the thread intra-abdominally were used. Results: Age ranged from 3 months to 12 years and 40 were males. Seven cases were bilat-eral making total 62 lesions. Mean operating time was 30.54 ± 5.84 min (range 20–42) and there was no intraoperative complication. Postoperatively five cases had transient hydrocele which resolved spontaneously. One case recurred after 2 months. Conclusions: Needle-assisted laparoscop...
Background : Endoscopic retrograde cholangiopancreatography (ERCP) is a universally established ... more Background : Endoscopic retrograde cholangiopancreatography (ERCP) is a universally established modality in the evaluation and treatment of adults with suspected biliary and pancreatic disease. Experience with ERCP in children has been relatively limited especially in a developing country like Bangladesh. Objective: Aim of this study is to evaluate the diagnostic and therapeutic yields of ERCP for biliary and pancreatic diseases in Bangladeshi children. Design and settings: This retrospective study was conducted in the departments of Gastroenterology & Hepatology of Bangabandhu Memorial Hospital and Chattagram Metropolitan Hospital, Chittagong, Bangladesh between 2004 and 2013. Patients: Seventy-three patients (14 males and 59 females) aged 1 year 7 months to 18 years with the suspicion of biliary or pancreatic diseases were included in this study. Interventions: Seventy-six procedures of ERCPs were performed. Main outcome measures: Common indications for ERCP and its therap...
Background: Health providers working in non-COVID hospitals in Bangladesh may be at an increased ... more Background: Health providers working in non-COVID hospitals in Bangladesh may be at an increased risk of infection with the new coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) compared to health providers working in COVID-dedicated hospitals due to lower health security measures. Consequently, health practitioners working at such hospitals may be the most vulnerable health group to stress-related problems and mental illness. To our knowledge, there is no study assessing stress-related problems in this particular population and how this group compares to those working in COVID-dedicated units in terms of pandemic-related stress.Methods: An online survey was carried out among 247 medical doctors from Bangladesh (101 females and 146 males). We report descriptive statistics and several group comparisons.Results: The overall stress level among participants was moderated. There were no statistically significant differences in pandemic-related stress between those...
Context: The outbreak of the Coronavirus disease 2019 (Covid-19) has posed new challenges to surg... more Context: The outbreak of the Coronavirus disease 2019 (Covid-19) has posed new challenges to surgical care throughout the world. Laparoscopic guidelines were revised to address the theoretical risks associated with transmission of viral droplets and many elective surgeries were suspended.Aims: We aimed to describe strategies that lowered viral transmission risks such as alternative anaesthetic techniques and low-cost infection control and prevention practices for laparoscopic surgeries.Settings and Design: Seventy two patients who presented to hospital as acute surgical emergencies between April and July 2020 and analyzed clinical data of 50 patients who underwent laparoscopic surgeries. This was a prospective observational study.Methods and Material: Procedures were performed under spinal anaesthesia utilizing alternate electrosurgical units and simple smoke evacuation systems.Statistical analysis used: Continuous variables were summarized as mean and standard deviation (SD) or med...
BACKGROUND Non-operative treatment (NOT) of pediatric appendicitis as opposed to surgery elicits ... more BACKGROUND Non-operative treatment (NOT) of pediatric appendicitis as opposed to surgery elicits great debate and is potentially influenced by physician preferences. Owing to the effects of the COVID pandemic on healthcare, the practice of NOT has generally increased by necessity and may, in a post-COVID world, change surgeons’ perceptions of NOT. OBJECTIVE The objective was to determine whether the use of NOT has increased in usage in South Asia and whether these levels of practice would be sustained after the pandemic subside. METHODS A survey was conducted by pediatric surgeons regarding their position, institute, country, number of appendicitis cases managed, and their mode of treatment between identical time periods in 2019 and 2020 (April 1 to August 31). It also directly posed the question as to whether they would continue with the COVID imposed level of NOT after the effect of pandemic diminishes. RESULTS A total of 134 responses were collected. A significant increase in the...
BackgroundSevere Acute Respiratory syndrome coronavirus 2 (SARS-CoV-2), which originated in Wuhan... more BackgroundSevere Acute Respiratory syndrome coronavirus 2 (SARS-CoV-2), which originated in Wuhan, China, has turned into a pandemic. All countries have implemented multiple strategies to try mitigating the losses caused by this virus. To stop the rapid spread of the disease and in compliance with the World Health Organization’s social distancing policy, the government of Bangladesh has implemented a number of strategies, one of which is to limit the spread of the virus in hospitals by postponing elective procedures and providing only emergency services in the hospitals.The objective of this survey was to assess the current status of pediatric surgical procedures in different hospitals in Bangladesh and assess the effects of the current restrictions along with their implications in the long run.Materials and MethodsA survey was performed among doctors from public and private hospitals in Bangladesh to evaluate the status on pediatric surgery.ResultsThe results clearly revealed the l...
STRUCTURED ABSTRACTBackgroundOwing to the widespread use of general anesthesia, administration of... more STRUCTURED ABSTRACTBackgroundOwing to the widespread use of general anesthesia, administration of spinal anesthesia in pediatrics is not widely practiced. Yet there is ample positive evidence demonstrating its safety, effectiveness and success.ObjectiveThe objective of this study is to demonstrate that laparoscopic appendectomies are successful under spinal anesthesia and elicit clear advantages over general anesthesia.MethodsThis was a retrospective analysis of 77 pediatric (5-8 year old) laparoscopic appendectomies that took place in a Hospital in Chittagong, Bangladesh in 2019. Approximately half of the patients underwent spinal anesthesia while the other half underwent general anesthesia. Variables such as surgery and operation theatre times, pain score, incidence of post-surgery vomiting, analgesic usage, discharge times and hospital costs were recorded. Statistical analysis was used to analyze the data as a function of form of anesthesia.ResultsThe probability of vomiting when...
ABSTRACTBackgroundNon-operative treatment (NOT) of pediatric appendicitis as opposed to surgery e... more ABSTRACTBackgroundNon-operative treatment (NOT) of pediatric appendicitis as opposed to surgery elicits great debate and is potentially influenced by physician preferences. Owing to the effects of the COVID pandemic on healthcare, the practice of NOT has generally increased by necessity and may, in a post-COVID world, change surgeons’ perceptions of NOT.ObjectiveThe objective was to determine whether the use of NOT has increased in usage in South Asia and whether these levels of practice would be sustained after the pandemic subside.MethodsA survey was conducted by pediatric surgeons regarding their position, institute, country, number of appendicitis cases managed, and their mode of treatment between identical time periods in 2019 and 2020 (April 1 to August 31). It also directly posed the question as to whether they would continue with the COVID imposed level of NOT after the effect of pandemic diminishes.ResultsA total of 134 responses were collected. A significant increase in th...
Background Laparoscopy can identify patients who would benefit from further surgical interventio... more Background Laparoscopy can identify patients who would benefit from further surgical intervention. Most importantly it is 100% sensitive in identifying the vanishing testicle. Aims To review the role of laparoscopy in the management of the undescended testis. Methods Thirty-one patients underwent a laparoscopy for an impalpable testicle over a nine-year period at this institution. Results There were 30 successful laparoscopies completed for 31 impalpable
Background Owing to the widespread use of general anesthesia, administration of spinal anesthesia... more Background Owing to the widespread use of general anesthesia, administration of spinal anesthesia in pediatric patients is not widely practiced. Yet there is ample positive evidence demonstrating its safety, effectiveness, and success. Objective The objective of this study is to compare postoperative patient comfort, length of hospital stay, and cost-effectiveness of pediatric laparoscopic appendectomies performed under spinal and general anesthesia with the usual standard-of-care procedures employed in the hospital. Methods This is a case series of 77 consecutive pediatric laparoscopic appendectomies (involving 5-8–year-old children) that took place in a hospital in Chittagong, Bangladesh, in 2019. A total of 40 patients underwent spinal anesthesia and 37 patients underwent general anesthesia. Variables such as surgery and operation theater times, pain score, incidence of postsurgery vomiting, analgesic usage, discharge times, and hospital costs were recorded. Statistical analysis ...
Background: COVID-19 has highly impacted the education system and has created trends in online cl... more Background: COVID-19 has highly impacted the education system and has created trends in online classes. To fill in the gap created by lockdown and to continue the uninterrupted learning process, educational institutions worldwide started organizing online classes. Although medical education is mostly practical, it is not safe to conduct on campus classes. This study aimed to measure the scope and limitations of online education and the overall impact of COVID-19 on the medical education system.Methodology: This was a cross-sectional study. Ethical approval was obtained from the ethical committee of the South Point Hospital. Informed consent was obtained. Self-administered questionnaires were administered to participants.Results: E-Learning opportunities were made available in 98.69% of cases; some student forums also participated. Among survey respondents, females predominated (57.39%), and 42% of respondents belonged to rural areas and small towns. Access and quality of internet du...
Purpose: There are numerous procedures of minimally invasive surgery for repair of inguinal herni... more Purpose: There are numerous procedures of minimally invasive surgery for repair of inguinal hernia in children including percutaneous techniques. We describe here our technique of using 18G or 20G needle in a very simple and effective way for this purpose. Methods: Needle-assisted laparoscopic percutaneous repair internal ring was performed in 55 children between 1st November 2010 and 31st July 2011. An 18G or 20G needle and a 3/0 polyglycolic acid thread were used. A 5-mm supraumbilical port for 30 5 mm telescope and a 3-mm port in iliac fossa opposite to the lesion to handle the thread intra-abdominally were used. Results: Age ranged from 3 months to 12 years and 40 were males. Seven cases were bilat-eral making total 62 lesions. Mean operating time was 30.54 ± 5.84 min (range 20–42) and there was no intraoperative complication. Postoperatively five cases had transient hydrocele which resolved spontaneously. One case recurred after 2 months. Conclusions: Needle-assisted laparoscop...
Background : Endoscopic retrograde cholangiopancreatography (ERCP) is a universally established ... more Background : Endoscopic retrograde cholangiopancreatography (ERCP) is a universally established modality in the evaluation and treatment of adults with suspected biliary and pancreatic disease. Experience with ERCP in children has been relatively limited especially in a developing country like Bangladesh. Objective: Aim of this study is to evaluate the diagnostic and therapeutic yields of ERCP for biliary and pancreatic diseases in Bangladeshi children. Design and settings: This retrospective study was conducted in the departments of Gastroenterology & Hepatology of Bangabandhu Memorial Hospital and Chattagram Metropolitan Hospital, Chittagong, Bangladesh between 2004 and 2013. Patients: Seventy-three patients (14 males and 59 females) aged 1 year 7 months to 18 years with the suspicion of biliary or pancreatic diseases were included in this study. Interventions: Seventy-six procedures of ERCPs were performed. Main outcome measures: Common indications for ERCP and its therap...
Background: Health providers working in non-COVID hospitals in Bangladesh may be at an increased ... more Background: Health providers working in non-COVID hospitals in Bangladesh may be at an increased risk of infection with the new coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) compared to health providers working in COVID-dedicated hospitals due to lower health security measures. Consequently, health practitioners working at such hospitals may be the most vulnerable health group to stress-related problems and mental illness. To our knowledge, there is no study assessing stress-related problems in this particular population and how this group compares to those working in COVID-dedicated units in terms of pandemic-related stress.Methods: An online survey was carried out among 247 medical doctors from Bangladesh (101 females and 146 males). We report descriptive statistics and several group comparisons.Results: The overall stress level among participants was moderated. There were no statistically significant differences in pandemic-related stress between those...
Context: The outbreak of the Coronavirus disease 2019 (Covid-19) has posed new challenges to surg... more Context: The outbreak of the Coronavirus disease 2019 (Covid-19) has posed new challenges to surgical care throughout the world. Laparoscopic guidelines were revised to address the theoretical risks associated with transmission of viral droplets and many elective surgeries were suspended.Aims: We aimed to describe strategies that lowered viral transmission risks such as alternative anaesthetic techniques and low-cost infection control and prevention practices for laparoscopic surgeries.Settings and Design: Seventy two patients who presented to hospital as acute surgical emergencies between April and July 2020 and analyzed clinical data of 50 patients who underwent laparoscopic surgeries. This was a prospective observational study.Methods and Material: Procedures were performed under spinal anaesthesia utilizing alternate electrosurgical units and simple smoke evacuation systems.Statistical analysis used: Continuous variables were summarized as mean and standard deviation (SD) or med...
BACKGROUND Non-operative treatment (NOT) of pediatric appendicitis as opposed to surgery elicits ... more BACKGROUND Non-operative treatment (NOT) of pediatric appendicitis as opposed to surgery elicits great debate and is potentially influenced by physician preferences. Owing to the effects of the COVID pandemic on healthcare, the practice of NOT has generally increased by necessity and may, in a post-COVID world, change surgeons’ perceptions of NOT. OBJECTIVE The objective was to determine whether the use of NOT has increased in usage in South Asia and whether these levels of practice would be sustained after the pandemic subside. METHODS A survey was conducted by pediatric surgeons regarding their position, institute, country, number of appendicitis cases managed, and their mode of treatment between identical time periods in 2019 and 2020 (April 1 to August 31). It also directly posed the question as to whether they would continue with the COVID imposed level of NOT after the effect of pandemic diminishes. RESULTS A total of 134 responses were collected. A significant increase in the...
BackgroundSevere Acute Respiratory syndrome coronavirus 2 (SARS-CoV-2), which originated in Wuhan... more BackgroundSevere Acute Respiratory syndrome coronavirus 2 (SARS-CoV-2), which originated in Wuhan, China, has turned into a pandemic. All countries have implemented multiple strategies to try mitigating the losses caused by this virus. To stop the rapid spread of the disease and in compliance with the World Health Organization’s social distancing policy, the government of Bangladesh has implemented a number of strategies, one of which is to limit the spread of the virus in hospitals by postponing elective procedures and providing only emergency services in the hospitals.The objective of this survey was to assess the current status of pediatric surgical procedures in different hospitals in Bangladesh and assess the effects of the current restrictions along with their implications in the long run.Materials and MethodsA survey was performed among doctors from public and private hospitals in Bangladesh to evaluate the status on pediatric surgery.ResultsThe results clearly revealed the l...
STRUCTURED ABSTRACTBackgroundOwing to the widespread use of general anesthesia, administration of... more STRUCTURED ABSTRACTBackgroundOwing to the widespread use of general anesthesia, administration of spinal anesthesia in pediatrics is not widely practiced. Yet there is ample positive evidence demonstrating its safety, effectiveness and success.ObjectiveThe objective of this study is to demonstrate that laparoscopic appendectomies are successful under spinal anesthesia and elicit clear advantages over general anesthesia.MethodsThis was a retrospective analysis of 77 pediatric (5-8 year old) laparoscopic appendectomies that took place in a Hospital in Chittagong, Bangladesh in 2019. Approximately half of the patients underwent spinal anesthesia while the other half underwent general anesthesia. Variables such as surgery and operation theatre times, pain score, incidence of post-surgery vomiting, analgesic usage, discharge times and hospital costs were recorded. Statistical analysis was used to analyze the data as a function of form of anesthesia.ResultsThe probability of vomiting when...
ABSTRACTBackgroundNon-operative treatment (NOT) of pediatric appendicitis as opposed to surgery e... more ABSTRACTBackgroundNon-operative treatment (NOT) of pediatric appendicitis as opposed to surgery elicits great debate and is potentially influenced by physician preferences. Owing to the effects of the COVID pandemic on healthcare, the practice of NOT has generally increased by necessity and may, in a post-COVID world, change surgeons’ perceptions of NOT.ObjectiveThe objective was to determine whether the use of NOT has increased in usage in South Asia and whether these levels of practice would be sustained after the pandemic subside.MethodsA survey was conducted by pediatric surgeons regarding their position, institute, country, number of appendicitis cases managed, and their mode of treatment between identical time periods in 2019 and 2020 (April 1 to August 31). It also directly posed the question as to whether they would continue with the COVID imposed level of NOT after the effect of pandemic diminishes.ResultsA total of 134 responses were collected. A significant increase in th...
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