Placenta percreta is an abnormal penetration of placental tissue through entire uterine wall and encroachment into the surrounding organs such as bladder and rectum. We present a case report of placenta percreta with bladder invasion to highlight the catastrophic nature of this clinical entity, which, if managed appropriately, is associated with a better outcome. A 29-year-old gravida 3, para 2 (both cesarean deliveries) was referred from a peripheral clinic to our tertiary care hospital with suspicion of major placenta previa accreta. She presented at 36 weeks gestation with complaints of continuous mild to moderate lower abdominal pain and hematuria for two days. Doppler ultrasound found central placenta previa extending up to bladder mucosa. Surgery was planned in collaboration with a multi-disciplinary team and was performed the following morning. A healthy baby girl was delivered by cesarean section followed by subtotal hysterectomy and bilateral internal iliac artery ligation leaving behind the whole placenta due to its morbid adherence to the bladder. Postoperatively methotrexate therapy was given. During follow-up, patient complained of urinary incontinence and underwent surgical correction in collaboration with a urologist. Patient had complete recovery at one year follow-up.

Porencephaly is a rare congenital disorder of the central nervous system involving a cyst or a cavity filled with cerebrospinal fluid in brain’s parenchyma. Prefrontal cortical dysfunction is often associated with development of psychotic symptoms. We present a case of a 26-year-old female with first episode of psychosis who was found to be suffering from porencephaly of left frontal cortex. There are only a few case reports of porencephaly associated with psychosis in literature. Porencephaly may contribute to the development of psychosis, especially if located in the frontal lobe of brain.

Gallstone disease is one of the commonest surgical ailments handled globally. Laparoscopic cholecystectomy is the gold standard treatment for symptomatic cholelithiasis. One of the rare anomalies of hepatobiliary system is situs inversus totalis. To the best of our knowledge, this is the second time that we encountered the symptomatic cholethiasis in a female patient, where- in laparoscopic cholecystectomy was performed with uneventful results. We present it as a rare case report with a special mention to the technique used therein.

BACKGROUND: The present survey was carried out to assess the dental caries status and treatment needs among the jail inmates, which would be helpful in planning suitable oral health care services in a prison setting.

METHODS: A descriptive cross-sectional study was performed on a population of 338 prisoners (males-256, females-82) in the Central Jail, Ferozepur, India. Clinical data were recorded using WHO Oral Health Assessment Form (1997) for assessing dental health status. The data were analyzed using the SPSS version 15.0 with Student’s t-test and ANOVA test.

RESULTS: The prevalence of dental caries was 92.6% with a higher prevalence among female inmates. The mean scores of decayed missing filled teeth (DMFT) increased with advancing age. Around 24.3% of the inmates had root caries and the most common required dental procedure was restorations along with extraction.

CONCLUSION: The prison population had high prevalence of dental caries and regular dental care should be provided to this community to improve their dental health status.

Guillain-Barré syndrome (GBS) is an acquired acute autoimmune polyradiculoneuropathy. Progressive motor weakness and areflexia are considered two essential features to diagnose GBS. But sometimes in axonal variants of GBS, there have been several descriptions of hyperreflexia. Although not common in South Asia, there have been several reports of hyperreflexic GBS. A 12-year-old girl presented with progressive lower limb weakness and was diagnosed as a case of hyperreflexic GBS. GBS is a common disease in Bangladesh but there have been no reports of the hyperreflexic variety.

Tracheobronchial injuries following blunt chest trauma are uncommon in children and usually present with acute signs and symptoms in the form of severe dyspnea, cyanosis, major air leak and surgical emphysema. In the present case report, a 6-year-old boy with left main bronchial rupture and complete collapse of the left lung following blunt chest trauma and unresolved left-sided pneumothorax 5 days after tube thoracostomy is introduced. Bronchoscopic examination showed severe injuries to the left main bronchus. Left posterolateral thoracotomy was performed. During the operation, we found a complete non-repairable T-shaped rupture in the left main bronchus at the proximal side associated with separation of the distal side. Due to post-bronchorrhaphy stenosis, pneumonectomy was performed.

Biliary fistulas can be internal or external. Most internal fistulas occur due to inflammatory diseases affecting the biliary tree whereas external fistulas mostly occur after surgery involving the biliary system. Gall bladder cancer presenting with cholecysto-cutaneous fistula is an extremely rare finding. We hereby report a case of a 62-year-old female who presented with a spontaneous cholecysto-cutaneous fistula from an underlying gall bladder cancer.