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ダッカ医大病院から先進医療を学ぶために東京女子医大病院で研修している
Dr. Nishat からの Feedback Report

留学生一覧
 

2015年 6月 Dr. Nishat からのFeedback Report

Dr.Nishat

With the grace of almighty Allah, I could overcome the difficulties and obstacles in Tokyo and thus could finish the one year training in Department of Plastic and Reconstructive Surgery, Tokyo Women’s Medical University. While writing this final report, I remember everyone who extended their helping hand of different magnitude towards me. I feel grateful to my trainers, fellow doctors, officials as well as even the mere Japanese passerby who became kind enough to show me something I was looking for in a helpless situation.

However, my clinical experience in the last one year was rich, though it mostly consisted different plastic surgical operative techniques. However, the following table elaborates the types of operations and techniques I had the opportunity to observe. I got the opportunity to perform some preliminary tasks in a few of these cases.

Name of the cases Number of the patients
Breast Reconstruction 31
Cleft lip and Palate 5
Facial bone fracture 23
Different Microsurgical Reconstructions (Other than breast reconstruction) 21
Hand surgery 11
LASER 10
Congenital Auricular deformities 2
Congenital Chest wall Deformities 56
Miscellaneous cases 40
Minor outdoor operations 36
Varicose veins 7
Pressure sores 5
Total 247

The term “Breast Reconstruction” included a number of different operative techniques which are enlisted in the following table:

Name of the Operation Number of cases
Deep Inferior Epigastric Artery Perforator Flap (DIEP) 11
Implant Expander reconstruction 9
Pedicled LD flap 2
Nipple Reconstruction 5
Reshaping of reconstructed breast  and Scar revision 4
Total 31

The miscellaneous cases included a variety of operations comprising different basic techniques of Plastic Surgery including Split Thickness skin Graft, Full Thickness Skin graft, Removal of benign and malignant tumors, Tissue Expansion, Different pedicled flaps, Removal of tattoo, Hepatic artery reconstruction, Treatment of vascular malformations, Lymphaticovenous anastomosis, Calvarial Reconstruction, Amputation of limbs, Repair of nerve injuries, Diabetic foot ulcers, release and reconstruction of scar contractures, Free bone graft for different purposes etc

All of these above mentioned procedures enriched my knowledge and skill in the field of Plastic Surgery. Though some of the procedures performed here are beyond the scope of my performance in my own country. So, sometimes I felt that, if the training module would be more structured focusing the surgical interest of respective trainee, it would be more fruitful and effective.

Everyone I came across in the course of my training was very kind to me. Besides academic matters. I learnt moral as well as cultural lessons from different doctors in different times. At the end of the tenure of my training, I received very warm farewell on behalf of JBMA and Department of Plastic Surgery, TWMU in separate arrangements.   I will never forget this honor. I always believe that this program is a beginning of medical relationship between Japan and Bangladesh and it has a long way to go. I also think that this is a great opportunity for Bangladeshi doctors to upgrade their medical skills, views and concepts. Still there are some scopes to make this program more fruitful and sustainable.

As a part of my gratefulness to JBMA, I will always like to contribute my efforts and helps to run this program. I hope, with the generous efforts by all the trainees and involved members of JBMA, this program will be able to set an example of Integrated International Medical Relationship. I wish the prosperity and success of Japan Bangladesh Medical Association.

Thank you

2015年 5月 Dr. Nishat からのFeedback Report

Dr.Nishat

Though this is the monthly report of 11th month of my stay in Japan, the bell has already been started to ring for my departure as all the preparations to say good bye has been set in.

However, this month started with a rare opportunity in my life. I had the experience to enjoy the first ever emergency free flap in my life. As I have said earlier, I have some fascination for hand surgery, this operation gave me more pleasure because it was an operation to save a hand. The patient’s hand was crushed by falling of a very heavy object on his hand which in the term of Plastic surgery is called “Mangled hand”. Saving a mangled hand is always a challenging task and I saw it to be successfully and efficiently done. The dorsal skin of the hand was crushed and damaged which was excised and coverage was done by means of a free ALT flap. Moreover, as the vascularity of index, middle and ring finger were also disrupted; it also needed to be reconstructed by means of arterial and venous anastomosis. Through this operation, I came to know the new concept "Flow-through flap".

In this month, besides the common operations I have seen a lot, some new operations also have been taken place. Two patients suffered from 3rd degree burn have been reconstructed with free flaps. One young girl, having burn in anterior trunk in childhood, have been suffering from post burn scar contracture in her mammary region. Her skin in sub mammary region was reconstructed with previously expanded scapular free flap. Another young man suffering from burn in different areas of his body, was previously covered by skin graft. But, later he developed post burn scar contracture in his hand. This caused him restricted movement in his hand. The contracture was released and the defect was reconstructed with free SIEA flap. So far, he is having a very good hand function. In my country, the hospital I work in, receives and treats a lot of burn patients. I hope reconstructive techniques I learn here for burn patients, will augment my knowledge and skill and thus will benefit the patients of my country.

2015年 4月 Dr. Nishat からのFeedback Report

Dr.Nishat

With the end of the April, I have finished 10 months in Tokyo. The spring is now in full flow and the weather is really very comfortable. In this nice spring there held the 58th Annual Conference of Japanese Society of Plastic and Reconstructive Surgeons in Kyoto. The excellent, traditional Kyoto overwhelmed me. However, the conference opened new doors in front of my eyes.

I came to know about many new terms like “supermicrosurgery”. A lot of new procedures were described and a number of new papers were presented. Though most of the papers were presented in Japanese language, some papers were also presented in English by guest foreign doctors. Vascularized lymph node transfer as a treatment of lymphoedema was really a new concept to me. I enjoyed the house full session of this paper.

I also enjoyed the procedure of transaxillary endoscopic insertion of breast Implant. I have seen a lot of operations of insertion of breast implant during my training in Tokyo Women’s Medical University, but all of them were done by traditional sub mammary approach. I read the procedure of transaxillary endoscopic approach in books previously, but I did not have any visual impression. In this presentation, the details of the procedure were demonstrated by video, which was interesting.

Though I did not have the opportunity to concentrate much on “hand surgery” in my 10 months stay in TWMU, I got the opportunity to attend the session of “hand surgery” and learnt new things. I came to know about “vascularized nail bed transfer” for achievement of the better aesthetic outcome of nail defects. The “vascularized pulp transfer” for better aesthetic outcome of fingertip defect was pleasant and enriched my knowledge.

There were sessions of different interests also. For example, in the session of limb reconstruction, I came to know that most of the cases of vascular crisis in Japan are dealt by plastic surgeons. This is different in our country. In our country there is another specialty called “vascular surgery”. They deal with such cases. The sessions of “breast reconstruction” were day long and kept to continue house full till the end. The worldwide increasing interest for breast reconstruction in plastic surgeons was naturally reflected in the Japanese conference also.

After finishing the conference, I had some opportunity to visit some famous places in Kyoto including Kin Kakuji temple, Ginkakuji temple etc. I thank to everyone including JBMA, who brought me the opportunity to attend this big conference in such a historical place in Japan.

2015年 3月 Dr. Nishat からのFeedback Report

Dr.Nishat

Possibly this is the best season according to most of the Japanese people. Though still a little chilling out there, the lovely Cherry Blossom called in Japanese language “HANAMI” announces the beginning of spring. I am lucky to finish my memorable stay in japan by this nice weather.

This month along with my usual activities in TWMU, I had the opportunity to visit Nihon University Hospital. The natural beauty of the hospital drew my attention at the beginning and I was fascinated. Later, the enthusiasm of the doctors of the hospital, heartiest welcome by learned Prof. Dr. Nakazawa made me overwhelmed. The careful teaching by Dr. Soejima, very friendly orientation by Dr. Kashimura grew my desire to visit this hospital for a longer time. However, I learned something which I can really apply in my country after I go back. I visited this hospital for one week.

Besides daily clinical experiences, I had an opportunity to give an oral presentation of an interesting patient with combined deformity with pigeon chest and funnel chest who was successfully treated by pectus bar insertion. The conference was held last month in Kamakura which is one of the oldest cities in Japan. Next month, I will have another chance to give a poster presentation in another Japan’s oldest city of Kyoto. I really appreciate the opportunity to give presentations in Japanese historic cities.

Moreover, I stared my clinical research in TWMU. My research topic is related to postoperative deep vein thrombosis formation in patients undergoing plastic and reconstructive surgery. To date, there are only few retrospective studies on postoperative venous thromboembolism in the field of plastic and reconstructive surgery, and less emphasis has been placed on the risk of venous thromboembolism. In contrast, this study is going to be a prospective study which will correlate the outcome of venous thromboembolism with presence of risk factors using Caprini Risk Assessment Model. I am interested in receiving training with vascular technologists how to diagnose deep vein thrombosis using duplex scanning so that I could continue my clinical research after I go back.

At the end of the month, I was honored to join the traditional way of celebrating Japanese Cherry blossom “Hanami Party”. I am grateful to Prof. Sakurai for being kind enough to invite me such a party.

At last I again thank Japan Bangladesh Medical Association (JBMA) for arranging such a nice schedule for making my stay in japan as worth as possible.

2015年 2月 Dr. Nishat からのFeedback Report

Dr.Nishat

The month of February came with different colours along with the changing of colours of nature.

This month along with my day to day activities, I had to remain busy with some literary activities.

I had to prepare the study plan for my upcoming research. The title is “Prevalence of post-operative Venous Thromboembolism in plastic and reconstructive surgery patients”. Prof. Dr. Yamaki Takashi will guide me in the research. I prepared and presented a paper titled “Experience of insertion of bar for Pigeon’s chest and Funnel chest simultaneously in same patient” in the conference of Japanese Society of Innovative Techniques in Plastic and Reconstructive Surgery. I am grateful to Dr. Kikuchi for giving me this rare opportunity. After the conference I enjoyed the sightseeing in Kamakura and delicious dinner with the participant doctors from TWMU.

In the last week I visited The East Medical Centre of TWMU. I thank Prof. Isago for his kind cooperation and providing me a warm environment which allowed me to learn some new techniques.

The month ended with great entertaining tour to Echigo Yuzawa for skiing. I will remember every moment of this trip including learning Ski, going for dinner, singing in Karaoke and so many things for a long time. I thank Dr. Hori and Dr. Katahira for taking heartiest care of me in training me how to do the ski. I thank everyone who brought me this memorable event.

2015年 1月 Dr. Nishat からのFeedback Report

Dr.Nishat

This month is the first month of 2015 and with the beginning of this month more than half of my stay in Tokyo has been started to pass. It is a chilling winter here in Tokyo but still the weather is enjoyable.

The hospital environment along with good air conditioning system in my staying place gave me comfort.

This month I observed and participated in the plastic surgical operations as usual which became a little monotonous for me. The operations I participated were Insertion of bar in congenital chest wall deformities, breast reconstruction, scar Revision, reconstruction of mandible with scapular free flap, various types of facial bone fractures etc.

The Plastic Surgery is a subject without any boundary. So, at this stage of my training I feel if I could have the opportunity to visit some specialized plastic surgical centers like Hand Surgery, Genitourinary Reconstruction, Aesthetic Surgery, Trauma Reconstruction centers etc. my visit in Japan would be more fruitful.

I hope the great opportunity that has been provided by JBMA for me, will find a new dimension of success.

I wish a very enthusiastic and prosperous year ahead of us for all who are concerned with JBMA.

2014年 12月 Dr. Nishat からのFeedback Report

Dr.Nishat

When I sit to write this report, half of my stay in Japan is over. It is full flown winter here in Tokyo, though no sign of snowfall yet. In last six months, I came to learn many of the Japanese culture and customs besides plastic surgery.

As it was the last month of 2014, it was busy with many other activities.

I went to my country to meet my family in this month and for this reason I missed the “Bonen-kai” of Department of Plastic and Reconstructive Surgery, TWMU. But I was provided with the opportunity to enjoy the “Bonen-kai” of Higashi iryo center of TWMU. I was overwhelmed by the hospitability of Prof. Isago Tsukasa and all other doctors of that hospital. I will remain grateful to all who provided me the opportunity.

On 25th November, there was another year ending party named “Mesu osame-kai”, which means end of all the operations of the year. It was also very enjoyable. These parties are excellent concepts and I feel the lack of such celebrations in my country which really augments the spirit of dedication to work.

Regarding the academic activities, I am about to start a clinical research under kind guidance of Prof. Takahashi Yamaki and at the onset I feel the ocean of difference in research activities between Bangladesh and Japan.

I will request JBMA to extend its support to continue such research activities by Bangladeshi doctors under guidance of scholar researchers from Japan. The advantage of such research activities is that it does not need someone to stay in Japan and it can be performed even from Bangladesh. In Bangladesh, we lack the environment and expertise to engage in research activities.

At the end, I would like to wish everyone concerned with Japan Bangladesh Medical Association a very happy new year.

Happy 2015!!!!!

2014年 11月 Dr. Nishat からのFeedback Report

Dr.Nishat

From the end of October, a good number of reconstructive microsurgical operations were taken place which were really very new for me and contributed into my experience.

In one patient maxillary defect was reconstructed with iliac crest free bone graft but the mucosal lining was reconstructed with Free Jejunum. The result was very good. Following this operation, a free osteocutaneous fibular flap for reconstruction of mandibular defect following excision of recurrence of squamous cell carcinoma was performed. Besides these, DIEP flap for breast reconstruction, LD flap for breast reconstruction, foot reconstruction with free SCIA flap was also performed in this month which enriched my knowledge and experience.

A number of burn patients were treated in this month and they were very quickly treated with early excision and skin grafting. In our country, we treat hundreds of burn patient every day but still there were something which I could learn. There was a clinical meeting to discuss about a young boy having post burn scar contracture involving his neck on 27th November. In the meeting I had the opportunity to talk on post burn scar contracture. It was really exciting to talk in front of a number of senior plastic surgeons from different institutes in Tokyo.

On the 25thof this month we received warm invitation from Prof. Motohiro Nozaki to join in a meeting which was followed by a dinner. It was a big opportunity for me to talk with a busy and knowledgeable person like him who has contributed a lot in the field of plastic surgery by writing many articles and editing in world famous text books.  Sensei provided us with valuable time listening to our opinions and experiences during our stay in Tokyo. The delicious dinner following the meeting was also mouthwatering. But more surprises were waiting for me. I received gifts for upcoming winter from Prof. Hiroyuki Sakurai and also a fashionable jacket from Japanese famous brand Uniqlo from Prof. Motohiro Nozaki. I acknowledge my sincere gratitude for their kindness. I think these warm moments will encourage my enthusiasm in my work.

2014年 10月 Dr. Nishat からのFeedback Report

Dr.Nishat

In our country treatment of facial bone fracture is usually done by oral and maxillofacial surgeons, which is the arena of Plastic Surgeons in Japan. In Tokyo Women’s Medical University I see a good number of Nasal bone fractures, Zygomatic fractures being corrected by Plastic Surgeons with meticulous technique giving utmost importance to the final aesthetic outcome as well as function. This performance is possibly not so intensely can be carried out by Oral and Maxillofacial Surgeons. So, I feel the desire to learn the techniques and apply in Bangladesh. But the diagnostic work up is also extensive. CT scan is expensive in Bangladesh and difficult for some people. Moreover, Ultrasonography is another diagnostic tool for facial bone fracture which is not usually performed by surgeons in our country due to lack of facilities. I am also trying to learn the techniques of ultrasonographic diagnosis.

So, I feel I have many things to learn here even outside the core plastic surgical procedures. But, I find myself postponed backwards and failed to keep pace with, due to obligatory cooking and preparing foods till midnight, which makes me drowsy and tired when I need devotion and concentration in learning. I think I deserve the opportunity to concentrate more in training.

However, this month brought me a great joyous moment when I heard the news of birth of my daughter. I thank to the almighty for this precious gift to me. I wish the blessing for wellbeing of my newborn daughter from everyone.

2014年 9月 Dr. Nishat からのFeedback Report

Dr.Nishat

Gentle breeze in Tokyo has started to become cold and it announces the commencement of winter which I have cherished since my arrival here. The fantastic autumn evening in Tokyo makes me nostalgic sometimes.

Besides attending Plastic Surgical Operations, I had a variety of activities like attending seminars, visiting other hospitals, going for some sightseeing etc. in this month.

On 3rd September I have visited Ageo Hospital with Prof. Hiroyuki Sakurai. Sensei gifted me a lovely journey in Green Car (Business class of the train). In Ageo Hospital, I saw some modern equipments like a microscope having facilities to check vascularity of a flap, Da Vinci surgical systems which gave me the taste of modern inventions in surgical field. I participated in two surgical operations. The visit was concluded by a delicious dinner consisting various Japanese fishes offered by the President of that hospital.

I have attended a Conference on Burn in Nihon University Hospital on 4th September. I also attend a conference on plastic Surgery of Kanto Region on 5th September in Tochomae.

On 15th of this month, I got the opportunity to enjoy the Japanese traditional sports event “Sumo” and became overwhelmed at its beauty. It is Dr. Hisato Konoeda whose enthusiastic effort could make it for me. On 23rd, he again offered me an excellent one day trip for sightseeing in Nasu Kogen, Aiju Wakamatsu, Tono Hetsuri and Fukushima.

At the end, the month became gloomy with the departure of Dr. Hisato Konoeda, who showed his kindness and extended his friendship towards me helping in every step in my life in Tokyo which introduced me to the width and depth of the heart of Japanese people. I wish his success in Toronto.

2014年 8月 Dr. Nishat からのFeedback Report

Dr.Nishat

Weeks have been passing by and my stay in Tokyo has completed second month. I have become more familiar with Tokyo life and working pattern of doctors in Keisei Geka in Tokyo Women’s Medical University.  I have attend a number of operations including a good number of Funnel Chest, Breast Reconstruction and multiple other different plastic surgical procedures. I have seen some LASER treatment procedures also which is usually not done in our country in Government hospitals. I have visited Yachiyo Hospital on 14th of this month and participated the Pectoralis Major muscle flap for coverage of sternal defect following wound dehiscence in Coronary Artery Bypass Graft operation. It was the courtesy by Prof. Masaki Takeuchi, who picked me up from my apartment and driven me in his car for a long distance to his hospital and dropped me again in front of my apartment. I also met Prof. Hirayama in his clinic on 19th of this month along with Prof. Hiroyuki Sakurai. It was a great contribution from Prof. Hiroyuki Sakurai who took me for lunch and dinner for a number of times and offered me delicious Japanese foods which provided me some scope to go out in Tokyo and made my time joyful.

However, walking in the streets of Tokyo, I feel the hardship everywhere in restaurants, shops and transportation, which forces me to compromise every aspect even getting the stomach fulfilled.  This thing reminds me that Tokyo is the most expensive city in the world and keeps me gloomy, restrains me from enjoying Tokyo. I want to enjoy my time in Japan and get as much as close to Japanese culture but I don’t know whether that will be feasible or not.

2014年 7月 Dr. Nishat からのFeedback Report

Dr.Nishat

It was the last week of February in this year when I came to know that I have been selected as the next participant in the Training programme in Tokyo Women’s Medical University Organized by Japan Bangladesh Medical Association. From that moment, the picture of a country full of beauty, honesty and hardwork started to play in my mind. The first Japanese ray of light, conveyed to me by Dr. Kunio Saiki with the advice to become a “Kokorojashi” meaning “The heart of Knight”, made me more adament for dedication. The wheels started to roll by uncountable mails by Miss Maiko Kunmi and Mrs. Fumiko Daikoku . As I am a Govt. Officer in Bangladesh, I had to get Govt. sanction of leave and permission from Ministry of Health in Bangladesh which was a lengthy procedure with meaningless demands which made me bother Prof. Hiroyuki Sakurai sensei time and again for getting an invitation letter of appropriate format. However, despite some anxious moments before getting the visa in an eleventh hour, a smooth and successful completion of all preparation and procedures brought me into this lovely country in time.

I was feeling gloomy leaving my parents, child and wife in watery eyes, but the enthusiastic reception by Dr. Jiro Kathahira along with his bright son Yutsuke, a delicious dinner with Yakiniku and kind allowance for a phone call to my country informing my safe arrival set me relaxed. Tokyo, being totally unknown to me with almost all signboards and directions written in Japanese language, started to become familiar by tiresome but patient guideline by Miss Maiko Kunimi who showed me the streets, subways like I usually do to my kid.

The most awaited moment arrived when I met my respected professor Dr. Hiroyuki Sakurai, whom I saw for the first time in my country and developed a desire to work under his guidance. Despite my poor efficiency in Japanese language, a warm acceptance from all the doctors of “Keisei Geka” and caring co operation by Mrs. Yumiko Shinori kept me confident that my stay in Japan is going to reach beyond my expectations. Access to all surgical operations from the very beginning and enormous learning opportunities made it promising.
The food, as expected became difficult for me due to my poor acquaintance with Japanese food and being novice in cooking. In order to cut the coat according to my pocket, I had to spend my time and stamina in cooking instead of buying foods, which sometimes kept me awaken till midnight. As a result, I had to remain drowsy in operation room which made me feel that if could spend my energry more in training in hospital, it would be worth for me. However, due to kind co operation and guidance from everyone I could fulfill the tasks of the Holy Ramadan and enjoy my holy festival EID.

The facilities provided in my living apartment belongs to first class, decorated with all modern electric equipments necessary for daily living along with continuous access to high speed internet connection.

The welcome dinner I was offered was full of enthusiasm, and of course aristocratic. All the credit goes to Prof. Sakurai sensei for finding a delicious bengali restaurant for me. The most attractive event came in the end. I was fortunate to enjoy a river cruise along with Hanabi show by the courtesy of professor emeritus Motohiro Nozaki sensei . This memory will remain in my heart for a long time as well as the kind man Prof. Nozaki sensei who created this great opportunity for me.
Undoubtedly I can say even now that It will be painful for me to say good bye to these kind people, who is teaching me not only plastic surgery but also how be kind and work worthfully for mankind.