Bangabandhu Sheikh Mujib Medical University Journal
Classical and reversal stapedotomy both are exclusively done in otosclerosis but definite informa... more Classical and reversal stapedotomy both are exclusively done in otosclerosis but definite information regarding surgical advances, postoperative results, complications and information about how and in which patients these surgical techniques should exclusively be used are a source of continuous discussions. This prospective observational study was conducted in the Department of Otolaryngology-Head & Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka from July 2019 to December 2020 o compare the outcomes of classical and reversal stapedotomy in patients with otosclerosis. Total 28 cases of otosclerosis who underwent stapedotomy were divided in to two groups i.e. Group A (classical stapedotomy) & Group B (reversal stapedotomy) with 14 patients in each group. All patients were followed up post-operatively up to 3 months with Pure-tone audiometry (PTA). There is no significant difference between classical and reversal stapedotomy approach in terms of hearing impr...
Objective:This study aimed to determine the prevalence of hearing impairment in Bangladeshi peopl... more Objective:This study aimed to determine the prevalence of hearing impairment in Bangladeshi people of all ages.Methods:A nationally representative cross-sectional survey was carried out in 2013. A total of 4260 subjects (1774 males and 2486 females), with a mean age of 32 years, participated. Hearing impairment was determined by pure tone audiometry and otoacoustic emissions testing.Results:Disabling hearing loss (greater than 40 dB loss in adults, and greater than 30 dB loss in children younger than 15 years, in their better hearing ears) was present in 9.6 per cent (95 per cent confidence interval, 8.5–10.8 per cent) of the respondents. Hearing loss was more prevalent in socio-economically deprived people and in those older than 60 years. Multiple logistic regression analysis identified age, socio-economic deprivation, family history, impacted ear wax, chronic suppurative otitis media, otitis media with effusion, and otitis externa as the significant predictors of disabling hearin...
Head and neck squamous cell carcinoma (HNSCC) 5 year study at BSMMU
Head and Neck Squamous Cell Carcinoma (HNSCC) are generally similar in their clinical features, e... more Head and Neck Squamous Cell Carcinoma (HNSCC) are generally similar in their clinical features, epidemiology and etiology although their natural and clinical history and treatment differ. Despite lot of improvement in diagnostic and management technique, there is little improvement in survival rate over the last few decades. This study was carried-out in a multidisciplinary tertiary level hospital (BSMMU), with a country-wide catchment area to see the burden of HNSCC existing in our country and their clinical pattern. The overall incidence rate of HNSCC in this study was (0.15%) i.e. 150 person in 1,00,000 population. Male incidence (0.19%) was higher than female (0.12%). This study revealed that carcinoma of the larynx (25.22%) and pyriform fossae (20.57%) were the main culprit, whereas buccal carcinoma was the main component (37.70%) in the female series. Highest incidence was found in the 6th decade in both sexes. As the treatment of HNSCC may be time consuming, requires multidis...
The objective of this study was to determine the efficacy of fine needle aspiration cytology in d... more The objective of this study was to determine the efficacy of fine needle aspiration cytology in diagnosis and management of thyroid swelling. The study evaluated the predictive value of Pre operative fine needle aspiration cytology (FNAC) in surgical decision making, by comparing this (FNAC) with the post operative histopathological diagnosis. Ninety patients who underwent thyroidectomy between Jan-2007 to Dec-2008 were analysed in the department of Otolaryngology and Head-Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka. All the patients underwent pre operative FNAC were included in this study. FNAC was accurate in 85 (94.44%) patients. Failure were mainly noted in cases of follicular neoplasm (lesion). Our result indicates that FNAC is helpful in the diagnosis and surgical planning of thyroid swelling. However, histopathological analysis is still remaining essential to distinguish follicular adenoma from follicular carcinoma.
Chattagram Maa-O-Shishu Hospital Medical College Journal, 2021
Background : Hearing impairment is one of the leading causes of disability in Bangladesh. Since h... more Background : Hearing impairment is one of the leading causes of disability in Bangladesh. Since half the cases can be prevented through public awareness, early detection and timely management, planning of public health interventions become necessary. To achieve this, a nationwide level of evidence is required. This survey was conducted with the aim of determining the prevalence of hearing impairment in Bangladesh. Materials and methods : The study was a cross-sectional one, conducted between January to May 2013, where a multistage, geographically clustered sampling approach was used. A total of 52 primary sampling units were selected, and from each unit households were selected at random followed by random selection of an individual from each household. In total, 5,220 people were targeted out of which data collection could be completed from 4260 individuals. (82%). Following clinical assessment of study subjects, hearing status was assessed by pure tone audiometry and otoacoustic emission test. Results : The mean age was 32 years among which 58% were females. Among men, there were 29% students, 28% agriculture workers and 14% business men. A major portion of females (63%) were home makers. On clinical examination, 11.5% respondents had impacted ear wax, 6.2% had chronic middle ear infections with eardrum perforation, and 5.3% had otitis media with effusion.On hearing assessment, 34.6% respondents had some form of hearing loss (>25dB in better ear). Conductive hearing loss was found in 12.0%, sensorineural in 4.5% and mixed in 3.8%, where the latter two increased in prevalence with age. Out of the total respondents, 9.6% had disabling hearing loss according to WHO criteria, with a higher prevalence in adults > 60 years(37%). Logistic regression analysis showed age, socioeconomic status, presence of ear wax, chronic suppurative otitis media, otitis media with effusion and otitis externa were significant predictors of disabling hearing loss. Conclusion : The major causes of conductive hearing loss are chronic suppurative otitis media and otitis media with effusion.
Background: Though ossicular discontinuity is more common in cases of cholesteatoma, it may happe... more Background: Though ossicular discontinuity is more common in cases of cholesteatoma, it may happen in non-cholesteatoma COM. The long process of incus is more frequently involved ossicle. Peroperative assessment of ossicular integrity is the gold standard way. But the discontinuity of the ossicular chain can be assumed before surgery by analyzing perforation edge adherent to medial wall and wide air-bone gap The purpose of the study was to find out the preoperative findings which can predict the ossicular discontinuity in non-cholesteatoma cases. Methods: This cross-sectional study was conducted in the department of Otolaryngology-Head & Neck Surgery, Bangabandhu Sheikh Mujib Medical University from January 2013 to June 2014. 81 patients of COM without cholesteatoma were selected as per inclusion and exclusion criteria. Relevant data were collected in a predesigned data collection sheet and analyzed with standard statistical method. Statistically significant inferred for P value <...
Bangladesh Medical Research Council Bulletin, 2021
Background: Occupational noise is considered as a global problem with social and physiological im... more Background: Occupational noise is considered as a global problem with social and physiological impacts, causing noise-induced hearing loss (NIHL). High levels of occupational noise is a problem in all regions of the world. Road traffic produces high noise levels that can cause damage to the traffic police hearing. Hence, occupational hearing loss is a well-known outcome of noise exposure at work. Objectives: The study aimed to measure the noise exposure level at different traffic points and determine the occurrence rate and severity of hearing loss among the traffic police of Dhaka Metropolitan City. Methods: This cross-sectional study was conducted during 2017-2019 in 28 selected traffic points of Dhaka Metropolitan City under four traffic zone (East, West, North, and South) and among 100 traffic police who were working there and met the inclusion and exclusion criteria. Noise exposure level was measured from all selected traffic points with a digital sound level meter. Data were c...
Background: Chronic otitis media (COM) is the long-standing infection of a part or whole of middl... more Background: Chronic otitis media (COM) is the long-standing infection of a part or whole of middle ear cleft characterized by ear discharge & perforation. The most common presenting symptoms are ear discharge, mild to severe hearing loss, sometimes tinnitus even vertigo. Treatment of COM is mainly operative. The treatment of inactive mucosal variety of COM is Type 1 tympanoplasty. It can be done by microscopic or endoscopic technique. Both methods have some merits and demerits. Objectives: Aim of the study was to compare the surgical outcomes between endoscopic and microscopic type 1 tympanoplasty. Methods: This study was carried out in the Department of Otolaryngology–Head & Neck surgery of Bangabandhu Sheikh Mujib Medical University, Dhaka from March 2017 to June 2019 and 60 (30 in each group) patient were included in the study. All patients underwent type 1 tympanoplasty. In Group A endoscopic tympanoplasty cases and in Group B microscopic tympanoplasty cases were placed. Operati...
Background: Schwannoma is mostly benign lesion that originates from the Schwannoma cells that cov... more Background: Schwannoma is mostly benign lesion that originates from the Schwannoma cells that cover the myelinated nerve fibers. Schwannoma arising from the tonsil are very rare. In head and neck region the incidence rate of schwannoma is between 25 to 45%. In most of the cases vestibular nerve followed by a parapharyngeal space is involved. It is also known as neurilemmoma. Objective: To diagnoses and manage the case of a Schwannoma of Tonsil. Findings: A case of tonsillar schwannoma in a 42 years old males was reported. The patient presented with unilateral enlargement of left tonsil with congested pharyngeal mucosa. Conclusion: Proper clinical examination with radiological assessment plays a vital role to diagnosis this accurately. Bangladesh Med Res Counc Bull 2020; 46(2): 142-144
Background: Chronic Otitis Media (COM) is a common disease in our country. COM with or without ch... more Background: Chronic Otitis Media (COM) is a common disease in our country. COM with or without cholesteatoma may lead to ossicular discontinuity. However, the discontinuity of the ossicular chain is usually confirmed during operation. The purpose of the study was to find out the correlation between preoperative hearing loss and the status of ossicular chain at surgery. Methods: This cross-sectional study was conducted in the department of otolaryngology- Head & neck surgery, Bangabandhu Sheikh Mujib Medical University from January 2013 to June 2014. At least 113 patients of COM were selected as per inclusion and exclusion criteria. Relevant data were collected in a predesigned data collection sheet and analyzed with standard statistical method. Statistically significant inferred for P value <0.05. No groups whose ability to give voluntary informed consent questionable was not included. No potential risks exist in designed this study. Results: Out of 34 patients with mild degree o...
Adenotonsillectomy is a commonly performed surgery for an Otolaryngologist. The most common compl... more Adenotonsillectomy is a commonly performed surgery for an Otolaryngologist. The most common complication is post operative bleeding. However, it can potentially be associated with several other complications. Subcutaneous emphysema after adenotonsillectomy one of the rare complication but potentially life threatening. A case of 6 years old boy who developed cervicofacial subcutaneous emphysema and pneumomediastinum following adenotonsillectomy is reported here. Bangladesh Med Res Counc Bull 2019; 45: 62-65
Expanding Access: Cost-effectiveness of Cochlear Implantation and Deaf Education in Asia
Otolaryngology–Head and Neck Surgery
Objective To determine the cost-effectiveness of cochlear implantation (CI) with mainstream educa... more Objective To determine the cost-effectiveness of cochlear implantation (CI) with mainstream education and deaf education with sign language for treatment of children with profound sensorineural hearing loss in low- and lower-middle income countries in Asia. Study Design Cost-effectiveness analysis. Setting Bangladesh, Cambodia, India, Indonesia, Nepal, Pakistan, Philippines, and Sri Lanka participated in the study. Subjects and Methods Costs were obtained from experts in each country with known costs and published data, with estimation when necessary. A disability-adjusted life-years model was applied with 3% discounting and 10-year length of analysis. A sensitivity analysis was performed to evaluate the effect of device cost, professional salaries, annual number of implants, and probability of device failure. Cost-effectiveness was determined with the World Health Organization standard of cost-effectiveness ratio per gross domestic product (CER/GDP) per capita <3. Results Deaf e...
patients, initially treated at our institution, are counted twice). Neck dissections consisted of... more patients, initially treated at our institution, are counted twice). Neck dissections consisted of levels II-V in 36 (46%), II-IV in 15 (19%), and I-V in 14 (18%) necks. The remaining 13 (17%) necks were dissected at a single level (nϭ8) or multiple levels (nϭ5) not noted above. Among all necks treated, metastatic adenopathy was confirmed pathologically as follows: 2.6% level I, 38% level II, 45% level III, 47% level IV, and 17% level V. Comparing primary and recurrent disease, there was no difference in nodal distribution for levels I-III. Level IV was positive in 33% of primary and 60% of recurrent groups (pϭ0.04). Level V was positive in 14% of primary and 19% of recurrent groups (pϭ0.70). Adjuvant I-131 was given in 30 (97%) primary cases and 14 (38 %) recurrent cases. At median follow-up of 37 (1-120) months, neck control was seen in 76 (97%) with only one recurrence (99% control) within a previously operated neck level. CONCLUSION: Neck dissection in PTC gives excellent control of regional disease. Based on the pathologic distribution of nodes, dissection should routinely include levels II-IV with attention and inclusion of level V based on imaging and intra-operative findings. Routine level I dissection is not necessary.
Metastatic neck node is not uncommon in the otolaryngology department of a tertiary level hospita... more Metastatic neck node is not uncommon in the otolaryngology department of a tertiary level hospital. Ignorance, illiteracy, delay in seeking medical advice and poor orientation of our general practitioners regarding management causes these patients to suffer from marked morbidity and mortality. It is a prospective study with random selection of sixty (60) cases of metastatic neck node admitted in the otolaryngology department of BSMMU and Dhaka Medical College Hospital during a period extending from September, 2002 to August, 2003. Here 53(88.33%) cases of metastatic neck nodes having a known primary in the head neck region and in other seven (11.67%) cases primary site of malignancy could not be detected. The commonest site of known primary was supraglottic larynx. Highest number 19 (31.67%) of presentation was seen in 5th decade. Male incidence 47 (78.33%) was more compared to female 13 (21.67%). Keywords: Neck gland, Metastatic neck node, Unknown primary.DOI: 10.3329/bjo.v15i1.430...
The objective of this study was to determine the efficacy of fine needle aspiration cytology indi... more The objective of this study was to determine the efficacy of fine needle aspiration cytology indiagnosis and management of thyroid swelling. The study evaluated the predictive value ofPre operative fine needle aspiration cytology (FNAC) in surgical decision making, by comparingthis (FNAC) with the post operative histopathological diagnosis.Ninety patients who underwent thyroidectomy between Jan-2007 to Dec-2008 were analysedin the department of Otolaryngology and Head-Neck Surgery, Bangabandhu Sheikh MujibMedical University, Dhaka. All the patients underwent pre operative FNAC were included inthis study.FNAC was accurate in 85 (94.44%) patients. Failure were mainly noted in cases of follicularneoplasm (lesion). Our result indicates that FNAC is helpful in the diagnosis and surgicalplanning of thyroid swelling. However, histopathological analysis is still remaining essential todistinguish follicular adenoma from follicular carcinoma.Key words: FNAC; Histopathology; Thyroid swellingDO...
Objectives: To find out the complication of parotid surgery and association of nerve injury with ... more Objectives: To find out the complication of parotid surgery and association of nerve injury with the type of disease pathology and type of parotid surgery.
Significant hearing impairment is an important & common birth defect that occurs 1 to 3 per 100 l... more Significant hearing impairment is an important & common birth defect that occurs 1 to 3 per 100 live births and 2 to 4 per 100 neonatal intensive Care units 1,2,3. South East Asia has the largest number of hearing impairment in the world & houses one third of the worlds hearing impaired population. WHO estimates that every year about 38,000 deaf children are born in this region. In Bangladesh 2600 babies born deaf annually where the population is almost 13,000,000. Unfortunately, for many babies, this disability remains undetected until it is too late to prevent undesirable & often irreversible damage. Early detection and the treatment of childhood hearing loss have remained very important health and social issues. It has been well established that early detection and treatment are essential for the acquisition of communication competence, important social skills, emotional well-being and positive self
Bangabandhu Sheikh Mujib Medical University Journal
Classical and reversal stapedotomy both are exclusively done in otosclerosis but definite informa... more Classical and reversal stapedotomy both are exclusively done in otosclerosis but definite information regarding surgical advances, postoperative results, complications and information about how and in which patients these surgical techniques should exclusively be used are a source of continuous discussions. This prospective observational study was conducted in the Department of Otolaryngology-Head & Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka from July 2019 to December 2020 o compare the outcomes of classical and reversal stapedotomy in patients with otosclerosis. Total 28 cases of otosclerosis who underwent stapedotomy were divided in to two groups i.e. Group A (classical stapedotomy) & Group B (reversal stapedotomy) with 14 patients in each group. All patients were followed up post-operatively up to 3 months with Pure-tone audiometry (PTA). There is no significant difference between classical and reversal stapedotomy approach in terms of hearing impr...
Objective:This study aimed to determine the prevalence of hearing impairment in Bangladeshi peopl... more Objective:This study aimed to determine the prevalence of hearing impairment in Bangladeshi people of all ages.Methods:A nationally representative cross-sectional survey was carried out in 2013. A total of 4260 subjects (1774 males and 2486 females), with a mean age of 32 years, participated. Hearing impairment was determined by pure tone audiometry and otoacoustic emissions testing.Results:Disabling hearing loss (greater than 40 dB loss in adults, and greater than 30 dB loss in children younger than 15 years, in their better hearing ears) was present in 9.6 per cent (95 per cent confidence interval, 8.5–10.8 per cent) of the respondents. Hearing loss was more prevalent in socio-economically deprived people and in those older than 60 years. Multiple logistic regression analysis identified age, socio-economic deprivation, family history, impacted ear wax, chronic suppurative otitis media, otitis media with effusion, and otitis externa as the significant predictors of disabling hearin...
Head and neck squamous cell carcinoma (HNSCC) 5 year study at BSMMU
Head and Neck Squamous Cell Carcinoma (HNSCC) are generally similar in their clinical features, e... more Head and Neck Squamous Cell Carcinoma (HNSCC) are generally similar in their clinical features, epidemiology and etiology although their natural and clinical history and treatment differ. Despite lot of improvement in diagnostic and management technique, there is little improvement in survival rate over the last few decades. This study was carried-out in a multidisciplinary tertiary level hospital (BSMMU), with a country-wide catchment area to see the burden of HNSCC existing in our country and their clinical pattern. The overall incidence rate of HNSCC in this study was (0.15%) i.e. 150 person in 1,00,000 population. Male incidence (0.19%) was higher than female (0.12%). This study revealed that carcinoma of the larynx (25.22%) and pyriform fossae (20.57%) were the main culprit, whereas buccal carcinoma was the main component (37.70%) in the female series. Highest incidence was found in the 6th decade in both sexes. As the treatment of HNSCC may be time consuming, requires multidis...
The objective of this study was to determine the efficacy of fine needle aspiration cytology in d... more The objective of this study was to determine the efficacy of fine needle aspiration cytology in diagnosis and management of thyroid swelling. The study evaluated the predictive value of Pre operative fine needle aspiration cytology (FNAC) in surgical decision making, by comparing this (FNAC) with the post operative histopathological diagnosis. Ninety patients who underwent thyroidectomy between Jan-2007 to Dec-2008 were analysed in the department of Otolaryngology and Head-Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka. All the patients underwent pre operative FNAC were included in this study. FNAC was accurate in 85 (94.44%) patients. Failure were mainly noted in cases of follicular neoplasm (lesion). Our result indicates that FNAC is helpful in the diagnosis and surgical planning of thyroid swelling. However, histopathological analysis is still remaining essential to distinguish follicular adenoma from follicular carcinoma.
Chattagram Maa-O-Shishu Hospital Medical College Journal, 2021
Background : Hearing impairment is one of the leading causes of disability in Bangladesh. Since h... more Background : Hearing impairment is one of the leading causes of disability in Bangladesh. Since half the cases can be prevented through public awareness, early detection and timely management, planning of public health interventions become necessary. To achieve this, a nationwide level of evidence is required. This survey was conducted with the aim of determining the prevalence of hearing impairment in Bangladesh. Materials and methods : The study was a cross-sectional one, conducted between January to May 2013, where a multistage, geographically clustered sampling approach was used. A total of 52 primary sampling units were selected, and from each unit households were selected at random followed by random selection of an individual from each household. In total, 5,220 people were targeted out of which data collection could be completed from 4260 individuals. (82%). Following clinical assessment of study subjects, hearing status was assessed by pure tone audiometry and otoacoustic emission test. Results : The mean age was 32 years among which 58% were females. Among men, there were 29% students, 28% agriculture workers and 14% business men. A major portion of females (63%) were home makers. On clinical examination, 11.5% respondents had impacted ear wax, 6.2% had chronic middle ear infections with eardrum perforation, and 5.3% had otitis media with effusion.On hearing assessment, 34.6% respondents had some form of hearing loss (>25dB in better ear). Conductive hearing loss was found in 12.0%, sensorineural in 4.5% and mixed in 3.8%, where the latter two increased in prevalence with age. Out of the total respondents, 9.6% had disabling hearing loss according to WHO criteria, with a higher prevalence in adults > 60 years(37%). Logistic regression analysis showed age, socioeconomic status, presence of ear wax, chronic suppurative otitis media, otitis media with effusion and otitis externa were significant predictors of disabling hearing loss. Conclusion : The major causes of conductive hearing loss are chronic suppurative otitis media and otitis media with effusion.
Background: Though ossicular discontinuity is more common in cases of cholesteatoma, it may happe... more Background: Though ossicular discontinuity is more common in cases of cholesteatoma, it may happen in non-cholesteatoma COM. The long process of incus is more frequently involved ossicle. Peroperative assessment of ossicular integrity is the gold standard way. But the discontinuity of the ossicular chain can be assumed before surgery by analyzing perforation edge adherent to medial wall and wide air-bone gap The purpose of the study was to find out the preoperative findings which can predict the ossicular discontinuity in non-cholesteatoma cases. Methods: This cross-sectional study was conducted in the department of Otolaryngology-Head & Neck Surgery, Bangabandhu Sheikh Mujib Medical University from January 2013 to June 2014. 81 patients of COM without cholesteatoma were selected as per inclusion and exclusion criteria. Relevant data were collected in a predesigned data collection sheet and analyzed with standard statistical method. Statistically significant inferred for P value <...
Bangladesh Medical Research Council Bulletin, 2021
Background: Occupational noise is considered as a global problem with social and physiological im... more Background: Occupational noise is considered as a global problem with social and physiological impacts, causing noise-induced hearing loss (NIHL). High levels of occupational noise is a problem in all regions of the world. Road traffic produces high noise levels that can cause damage to the traffic police hearing. Hence, occupational hearing loss is a well-known outcome of noise exposure at work. Objectives: The study aimed to measure the noise exposure level at different traffic points and determine the occurrence rate and severity of hearing loss among the traffic police of Dhaka Metropolitan City. Methods: This cross-sectional study was conducted during 2017-2019 in 28 selected traffic points of Dhaka Metropolitan City under four traffic zone (East, West, North, and South) and among 100 traffic police who were working there and met the inclusion and exclusion criteria. Noise exposure level was measured from all selected traffic points with a digital sound level meter. Data were c...
Background: Chronic otitis media (COM) is the long-standing infection of a part or whole of middl... more Background: Chronic otitis media (COM) is the long-standing infection of a part or whole of middle ear cleft characterized by ear discharge & perforation. The most common presenting symptoms are ear discharge, mild to severe hearing loss, sometimes tinnitus even vertigo. Treatment of COM is mainly operative. The treatment of inactive mucosal variety of COM is Type 1 tympanoplasty. It can be done by microscopic or endoscopic technique. Both methods have some merits and demerits. Objectives: Aim of the study was to compare the surgical outcomes between endoscopic and microscopic type 1 tympanoplasty. Methods: This study was carried out in the Department of Otolaryngology–Head & Neck surgery of Bangabandhu Sheikh Mujib Medical University, Dhaka from March 2017 to June 2019 and 60 (30 in each group) patient were included in the study. All patients underwent type 1 tympanoplasty. In Group A endoscopic tympanoplasty cases and in Group B microscopic tympanoplasty cases were placed. Operati...
Background: Schwannoma is mostly benign lesion that originates from the Schwannoma cells that cov... more Background: Schwannoma is mostly benign lesion that originates from the Schwannoma cells that cover the myelinated nerve fibers. Schwannoma arising from the tonsil are very rare. In head and neck region the incidence rate of schwannoma is between 25 to 45%. In most of the cases vestibular nerve followed by a parapharyngeal space is involved. It is also known as neurilemmoma. Objective: To diagnoses and manage the case of a Schwannoma of Tonsil. Findings: A case of tonsillar schwannoma in a 42 years old males was reported. The patient presented with unilateral enlargement of left tonsil with congested pharyngeal mucosa. Conclusion: Proper clinical examination with radiological assessment plays a vital role to diagnosis this accurately. Bangladesh Med Res Counc Bull 2020; 46(2): 142-144
Background: Chronic Otitis Media (COM) is a common disease in our country. COM with or without ch... more Background: Chronic Otitis Media (COM) is a common disease in our country. COM with or without cholesteatoma may lead to ossicular discontinuity. However, the discontinuity of the ossicular chain is usually confirmed during operation. The purpose of the study was to find out the correlation between preoperative hearing loss and the status of ossicular chain at surgery. Methods: This cross-sectional study was conducted in the department of otolaryngology- Head & neck surgery, Bangabandhu Sheikh Mujib Medical University from January 2013 to June 2014. At least 113 patients of COM were selected as per inclusion and exclusion criteria. Relevant data were collected in a predesigned data collection sheet and analyzed with standard statistical method. Statistically significant inferred for P value <0.05. No groups whose ability to give voluntary informed consent questionable was not included. No potential risks exist in designed this study. Results: Out of 34 patients with mild degree o...
Adenotonsillectomy is a commonly performed surgery for an Otolaryngologist. The most common compl... more Adenotonsillectomy is a commonly performed surgery for an Otolaryngologist. The most common complication is post operative bleeding. However, it can potentially be associated with several other complications. Subcutaneous emphysema after adenotonsillectomy one of the rare complication but potentially life threatening. A case of 6 years old boy who developed cervicofacial subcutaneous emphysema and pneumomediastinum following adenotonsillectomy is reported here. Bangladesh Med Res Counc Bull 2019; 45: 62-65
Expanding Access: Cost-effectiveness of Cochlear Implantation and Deaf Education in Asia
Otolaryngology–Head and Neck Surgery
Objective To determine the cost-effectiveness of cochlear implantation (CI) with mainstream educa... more Objective To determine the cost-effectiveness of cochlear implantation (CI) with mainstream education and deaf education with sign language for treatment of children with profound sensorineural hearing loss in low- and lower-middle income countries in Asia. Study Design Cost-effectiveness analysis. Setting Bangladesh, Cambodia, India, Indonesia, Nepal, Pakistan, Philippines, and Sri Lanka participated in the study. Subjects and Methods Costs were obtained from experts in each country with known costs and published data, with estimation when necessary. A disability-adjusted life-years model was applied with 3% discounting and 10-year length of analysis. A sensitivity analysis was performed to evaluate the effect of device cost, professional salaries, annual number of implants, and probability of device failure. Cost-effectiveness was determined with the World Health Organization standard of cost-effectiveness ratio per gross domestic product (CER/GDP) per capita <3. Results Deaf e...
patients, initially treated at our institution, are counted twice). Neck dissections consisted of... more patients, initially treated at our institution, are counted twice). Neck dissections consisted of levels II-V in 36 (46%), II-IV in 15 (19%), and I-V in 14 (18%) necks. The remaining 13 (17%) necks were dissected at a single level (nϭ8) or multiple levels (nϭ5) not noted above. Among all necks treated, metastatic adenopathy was confirmed pathologically as follows: 2.6% level I, 38% level II, 45% level III, 47% level IV, and 17% level V. Comparing primary and recurrent disease, there was no difference in nodal distribution for levels I-III. Level IV was positive in 33% of primary and 60% of recurrent groups (pϭ0.04). Level V was positive in 14% of primary and 19% of recurrent groups (pϭ0.70). Adjuvant I-131 was given in 30 (97%) primary cases and 14 (38 %) recurrent cases. At median follow-up of 37 (1-120) months, neck control was seen in 76 (97%) with only one recurrence (99% control) within a previously operated neck level. CONCLUSION: Neck dissection in PTC gives excellent control of regional disease. Based on the pathologic distribution of nodes, dissection should routinely include levels II-IV with attention and inclusion of level V based on imaging and intra-operative findings. Routine level I dissection is not necessary.
Metastatic neck node is not uncommon in the otolaryngology department of a tertiary level hospita... more Metastatic neck node is not uncommon in the otolaryngology department of a tertiary level hospital. Ignorance, illiteracy, delay in seeking medical advice and poor orientation of our general practitioners regarding management causes these patients to suffer from marked morbidity and mortality. It is a prospective study with random selection of sixty (60) cases of metastatic neck node admitted in the otolaryngology department of BSMMU and Dhaka Medical College Hospital during a period extending from September, 2002 to August, 2003. Here 53(88.33%) cases of metastatic neck nodes having a known primary in the head neck region and in other seven (11.67%) cases primary site of malignancy could not be detected. The commonest site of known primary was supraglottic larynx. Highest number 19 (31.67%) of presentation was seen in 5th decade. Male incidence 47 (78.33%) was more compared to female 13 (21.67%). Keywords: Neck gland, Metastatic neck node, Unknown primary.DOI: 10.3329/bjo.v15i1.430...
The objective of this study was to determine the efficacy of fine needle aspiration cytology indi... more The objective of this study was to determine the efficacy of fine needle aspiration cytology indiagnosis and management of thyroid swelling. The study evaluated the predictive value ofPre operative fine needle aspiration cytology (FNAC) in surgical decision making, by comparingthis (FNAC) with the post operative histopathological diagnosis.Ninety patients who underwent thyroidectomy between Jan-2007 to Dec-2008 were analysedin the department of Otolaryngology and Head-Neck Surgery, Bangabandhu Sheikh MujibMedical University, Dhaka. All the patients underwent pre operative FNAC were included inthis study.FNAC was accurate in 85 (94.44%) patients. Failure were mainly noted in cases of follicularneoplasm (lesion). Our result indicates that FNAC is helpful in the diagnosis and surgicalplanning of thyroid swelling. However, histopathological analysis is still remaining essential todistinguish follicular adenoma from follicular carcinoma.Key words: FNAC; Histopathology; Thyroid swellingDO...
Objectives: To find out the complication of parotid surgery and association of nerve injury with ... more Objectives: To find out the complication of parotid surgery and association of nerve injury with the type of disease pathology and type of parotid surgery.
Significant hearing impairment is an important & common birth defect that occurs 1 to 3 per 100 l... more Significant hearing impairment is an important & common birth defect that occurs 1 to 3 per 100 live births and 2 to 4 per 100 neonatal intensive Care units 1,2,3. South East Asia has the largest number of hearing impairment in the world & houses one third of the worlds hearing impaired population. WHO estimates that every year about 38,000 deaf children are born in this region. In Bangladesh 2600 babies born deaf annually where the population is almost 13,000,000. Unfortunately, for many babies, this disability remains undetected until it is too late to prevent undesirable & often irreversible damage. Early detection and the treatment of childhood hearing loss have remained very important health and social issues. It has been well established that early detection and treatment are essential for the acquisition of communication competence, important social skills, emotional well-being and positive self
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