Pleomorphic adenoma is the most common benign salivary gland tumor, predominantly affecting the parotid gland. Despite its benign nature, surgical excision carries significant risks, notably facial nerve injury and postoperative complications such as Frey’s syndrome. This case report discusses the presentation, diagnosis, surgical management, and postoperative challenges of a long-standing parotid tumor in a male patient, emphasizing the delicate balance between complete tumor removal and preservation of facial nerve function. A 58-year-old male, Mr. Toslim Ali, presented with a ten-year history of a slowly enlarging, painless left parotid swelling extending from the preauricular region to the upper neck. Clinical and imaging findings were consistent with a parotid mass. Fine needle aspiration cytology (FNAC) suggested a benign lesion. A superficial parotidectomy was performed under general anesthesia. Intraoperative findings revealed a well-encapsulated mass adherent to the parotid fascia but without evidence of deep lobe invasion. Facial nerve branches were carefully dissected and preserved. Histopathology confirmed pleomorphic adenoma. Postoperatively, the patient recovered without major complications, experiencing only mild transient facial weakness that resolved within four weeks. This case underscores the clinical importance of early surgical intervention in pleomorphic adenoma, meticulous intraoperative dissection for facial nerve preservation, and the need for patient counseling regarding potential complications. The discussion integrates literature on surgical approaches, risk factors, and preventive techniques for parotidectomy-related complications such as facial nerve injury and Frey’s syndrome.

Background: Saddle block anesthesia is widely used for perianal surgeries; however, postoperative analgesia remains limited when local anesthetics are used alone. This study aimed to compare the effects of intrathecal dexmedetomidine and fentanyl as adjuvants to hyperbaric bupivacaine in saddle block for perianal surgeries Methods: This observational study in the Department of Anaesthesia, Analgesia, and Intensive Care Medicine at Bangabandhu Sheikh Mujib Medical University Hospital enrolled 64 adults (ASA I–II, 40–60 years) undergoing perianal surgery under saddle block, randomly receiving hyperbaric bupivacaine 7.5 mg with fentanyl 15 μg or dexmedetomidine 5 μg; outcomes included duration of analgesia, pain, sensory and motor block, hemodynamics, patient satisfaction, and adverse events, analyzed using SPSS v23.0. Results: Among 64 patients (mean age 45.3 ± 8.5 years; 48 males, 75%), postoperative VAS scores were lower in the dexmedetomidine group at all time points (peak 4 h: 2.75 vs 3.75). Duration of analgesia was longer with dexmedetomidine (278.5 ± 16.2 min) than fentanyl (198.7 ± 25.2 min, P = 0.0001). Motor and sensory block durations were also prolonged (162.5 vs 126.5 min and 292.1 vs 205.6 min, respectively). Hemodynamics remained stable, and adverse events were minimal (hypotension 2/32 vs 0/32; nausea/vomiting 5/32 vs 8/32; pruritus 4/32 vs 0/32). Conclusion: Dexmedetomidine as an adjuvant to hyperbaric bupivacaine in perianal surgeries under saddle block offers longer analgesia, lower pain scores, and faster sensory block onset than fentanyl.

Background: Pilonidal sinus is a chronic disease of the sacrococcygeal region, commonly seen in young adults, and is characterized by midline pits in the natal cleft associated with hair. This study was conducted to evaluate the outcomes of the Limberg flap procedure in the treatment of primary pilonidal sinus, including postoperative complications, duration of hospital stay, and time to return to work. Methods: This prospective observational study at the Department of Colorectal Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh (July 2019–August 2020), included 18 adults with primary pilonidal sinus. Excluding acute abscess and recurrent cases, patients underwent Limberg flap surgery under spinal anesthesia. Demographic, clinical, and outcome data were recorded, with follow-up at 2 weeks, and 1st, 3rd, 6th, and 9th months. Data were analyzed using SPSS® 24. Results: Among 18 patients undergoing Limberg flap repair, mean age was 26.9 ± 5.2 years, 88.9% were male, and most had BMI 18.5–24.9 kg/m². Single external opening was present in 83.3%. Mean operative time was 88.8 ± 12.7 minutes, hospital stay 4.17 ± 0.7 days, drain removal 3.4 ± 0.7 days, suture removal 12.9 ± 1.7 days, and return to work 12.7 ± 1.8 days. Postoperative complications occurred in 5 patients (27.7%), with no recurrences. Four of 5 overweight patients developed complications (r = 0.93, p < 0.001). Conclusion: The Limberg flap is a safe and effective treatment for sacrococcygeal pilonidal sinus, offering low recurrence, minimal complications, and rapid recovery.

This work is about the brain chemicals, and their possible natural catabolic products. Effort has been made to identify if the microwave frequencies of these by products are same as the microwave frequency ranges of sodium and Potassium in ionic solutions present in as well as outside a neurone. It could be a factor responsible for dementia. It is found that excess by products of Tau fragment and Human prion peptide 2 had the same microwave frequency of sodium and Potassium in ionic solutions present in as well as outside a neurone. Therefore, it can affect the neuronal functioning. Efforts have also been made to identify, if any of these Brain chemical bind to each other and block the normal neuronal functioning. In this effort, it is noted that, excess of Human prion peptide 1 can bind to Tau-441 protein. This can affect neuronal function.