ABSTRACT
Introduction: The concept of "Wide Awake Local Anesthesia No Tourniquet" (WALANT) technique is gaining popularity in the field of plastic, orthopedic and general surgery owing to its benefits of reduced cost, improved safety, improved patient satisfaction, avoiding costly preoperative tests, decreased operative time, reduced utilization of hospital resources and length of hospital stay. Objective: To determine indications for surgery and early outcomes of "Wide Awake Local Anesthesia No Tourniquet" among patients undergoing surgical procedures at Bugando Medical Centre (BMC). Method: This was a 4 months’ prospective longitudinal study conducted from April to July 2023 involving 91 patients aged 12 years and above who underwent surgical procedures from plastic, orthopaedics and general surgery departments at Bugando Medical Centre. Structured questionnaire was used to obtain operative information and the Visual Analogue Scale (VAS) was used to obtain intra operative pain score. Results: The most common indication for using WALANT was surgeon's preference (65/91,70%). The most common procedure done was sloughectomy (16/91,17.6%) the least being colostomy placement (1/91, 1.1%). Intraoperative VAS score range from 0 to 4 with a mean of 1.1 (±0.39). (88/91, 97%) of the participants had no any complication post-operatively and the majority of the remaining few presented with tachycardia (2/91, 2.2%). The level of satisfaction was significant associated with the length of hospital stay having the p-value of 0.00. Conclusions: The WALANT technique can be performed as the best alternative type of anesthesia for both minor and selected major surgeries with minimal pain score, high patient’s satisfaction rate, minimum risk of infection and significant reduced length of hospital stay.

ABSTRACT
Background: Although the incidence of ovarian cancer is less than that of other female cancers, the morbidity and mortality associated with the disease course is high. Because treatment involves radical surgery and intense courses of chemotherapy, health-related quality of life (HRQOL) is often compromised. Most patients recur post-first-line therapy and undergo multiple rounds of chemotherapy. Thus, HRQOL is further disrupted. Objective: The aim of this study is to assess impact of the treatment-free interval on health-related quality of life in patients with early-stage serous epithelial ovarian cancer. Methods: The cross-sectional observational study was conducted in the Department of Gynecological Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. A total 38 women with histopathologically confirmed serous epithelial ovarian cancer were included in the study. Participants were divided into two groups according to their mutation status; patients with BRCA mutation were Exposed Group and those without BRCA mutation as Unexposed Group. The questionnaire was pretested, corrected and finalized. Data were collected by face-to-face interview and analyzed by appropriate computer based programmed software Statistical Package for the Social Sciences (SPSS), version 24. Results: In this study, maximum study subjects 26 (68.4%) were in >45 years age group and 12 (31.6%) were in ≤45 years age group. Mean age of the study subjects was 52.43±4.22 years and majority of the patients 29 (76.3%) were literate and 9 (23.7%) were illiterate. About 25 (65.8%) respondents had family history of breast / ovarian cancer and 11 (28.9%) had no family history of breast / ovarian cancer. Majority 20 (52.6%) respondents underwent Primary Debulking Surgery as primary treatment modality, whereas 18 (47.4%) did not receive Primary Debulking Surgery and majority respondents 21 (55.3%) received neoadjuvant chemotherapy and interval debulking surgery, whereas 19 (44.7%) ..........

ABSTRACT
Background: Cardiovascular diseases, including stroke, heart failure and kidney disease, have been common in sub-Saharan Africa for many years. These cardiovascular diseases have been linked to several risk factors which are classified as modifiable and non-modifiable risk factors. This study assessed the prevalence of cardiovascular risk factors amongst middle-aged adults attending the outpatient clinic of Ekiti State University Teaching Hospital (EKSUTH), Ado Ekiti, Ekiti state. Methods: A cross-sectional descriptive study of 206 middle-aged adults attending the outpatient clinic was carried out over 4 months. The respondents were selected through systematic sampling. The instrument used was a structured questionnaire. Data analysis was done using Statistical Package for service solution (SPSS) version 23. Results: The respondents were aged 40-64 years, with a mean age of 51.47±7.83. There was a high prevalence of cardiovascular risk profiles among middle-aged adults with the prevalence of dyslipidaemia and hypertension being 73.3% and 46.1% respectively. Conclusion: This study shows the high prevalence of cardiovascular risk factors in middle-aged adults. Family physicians should therefore actively seek to screen their patients for cardiovascular risks while also engaging in the education of patients on positively modifying the modifiable risk factors.

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Background: Thyroid disorders (hyperthyroidism and hypothyroidism) have been known to affect renal function although studies regarding this are scanty. The goal of this study is to evaluate renal dysfunction in newly diagnosed untreated patients with hyperthyroidism and hypothyroidism using serum cystatin C. Methods: A total of 115 patients, 70 females and 45 males age 20 – 55 years with 60 cases of newly diagnosed hyperthyroidism and 55 cases of newly diagnosed hypothyroidism as well as 80 healthy controls (50 females and 30 males) matched for sex and age. Serum levels of thyrotropin (TSH), free tri-iodothyronine (fT3), free tetraiodothyronine (fT4) and cystatin C were measured in all the cases and controls. Serum fT3, fT4 and TSH was analyzed by enzyme linked immunosorbent assay (ELISA) technique using stat – fax- 2100. The serum cystatin C was evaluated using immunoturbidimetric method on TOSOH AIA 360 immuno assay machine. Results: In this study, serum cystatin C levels were significantly higher in both hyperthyroid and hypothyroid patients compared to controls (1.06 + 0.12 vs 1.26 + 0.27 vs 0.7 + 0.14; P - 0.01). Conclusion: Renal dysfunction has been observed in patients with untreated thyroid disorders and therefore, there is need to screen all such patients for renal function.

ABSTRACT
Background: The lifetime incidence of inguinal hernia is 3% in women and 27% in males. Although surgery is the advised course of action, opinions on the most effective technique are divided. Though there are worries about the possibility of chronic groin pain, open repair is the most common method. The recurrence rate of laparoscopic repair is yet unknown, but it is becoming more and more accepted because of the decreased risk of chronic discomfort. This overview compares the risk of chronic groin pain and recurrence between laparoscopic and open inguinal hernia repairs. Objective: The aim of this study is to assess the comparative efficiency between laparoscopic versus open surgery for inguinal hernia repair. Methods: The cross-sectional observational study was conducted in the Department of Surgery, Avicenna Hospital Limited, Sirajganj, Bangladesh, from July 2022 to June 2023. A total of 50 patients were enrolled and analyzed in this study. The questionnaire was pretested, corrected and finalized. Data were collected by face-to-face interview and analyzed by appropriate computer based programmed software Statistical Package for the Social Sciences (SPSS), version 24. Results: In this study, maximum study patients were in the 41 – 50 years age group. The mean age of the study patients was 41.2 ± 9.2 and 45.1 ± 13.2 years in Laparoscopic surgery and Open surgery group respectively. Most of the patients 22(88.0%) and 23 (92.0%) were male in Laparoscopic surgery group and Open surgery group. About 12 (48.0%) and 8 (32.0%) patients BMI were in between 25.0 – 29.9 kg/m2, 6 (24.0%) and 14 (56.0%) patients BMI in between 18.5 – 24.9 kg/m2 and 7(28.0%) and 3(12.0%) of the patients were overweight (>30 kg/m2) in both Laparoscopic surgery and Open surgery group. Mean ± SD of the study subjects was 25.13 ± 3.12 and 24.02 ± 2.72 years in Laparoscopic surgery and Open surgery group respectively. The period of complaint prior to surgery was 1 – 2 months of 14(56.0%) ..........