The word’ KOKOROZASHI’ –very first day of my came to Japan, harbour this spirit and embrace it in my every work. By the Grace of Almighty Allah , successfully completed my advanced clinical training program on Plastic and Reconstructive surgery in Dpt. of Plastic and Reconstructive surgery at TWMU.

I would like to express my heart-felt gratitude to all personnel of this training program. Thanks to Professor Motohiro Nozaki sensei, president of JBMA, Vice-President Professor Hiroyuki Sakurai sensei, Treasurer –Professor Masaki Takeuchi sensei, Secretary General Mrs. Iwata Izumi , Secretary General [Bangladesh] Dr. Sheikh Aleemuzzaman sir, included all members of JBMA for their support to run this program.

Thanks to all doctors and office staff of plastic surgery dpt. and also thanks to referral dpt. of TWMU, thanks to international office Mrs. Fumiko Daikoku.

Thanks to Director of this hospital, all anesthesiologist, nurses, OT staffs for their cooperation.

Within 1 year of my training, I have seen and learned quality of operations. Though free flap surgery is steep learning curve, moreover I had experienced with significant number of reconstructions. Other than free flap, I did cover almost all sites of my subject. Two important thing being a skilled specialist- one is professionalism –that is knowledge, skills and dedication another is humanity, I learnt from them. I take it in my heart and will continue till my death.

My farewell party date was 9th June of this month. Infact my party organized by our dpt. made me sympathetized. Last 1 year I was a member of this Family, but after that I shall no more. How could I forget everyone? Never forget their debt. I am debtor by them.

I will miss Keiseigeka, miss my mentor Professor Sakurai sensei and his team, our office staff, their sweet words, everything. But I always convey their etiquettes to my practice in Bangladesh.

Remember and thanks to well wisher Uniqlo and YKK.

And finally thanks to my parents, my respected teachers of Bangladesh, my wife, sons, relatives and friends for their encouraging support.

This month ‘May ‘starts with golden week. Almost 6 day’s holiday. I was waiting to receive Dr. Maruful Islam [plastic surgeon of Bangladesh], who self-wished to come Japan for 3 weeks advanced plastic surgery training under care of Professor Hiroyuki Sakurai sensei in plastic surgery dpt. of TWMU. I received him from Haneda airport on 6^th may. I introduced him in our dpt’s colleagues and office staff. Professor Sakurai sensei wants to give a reception party and because we were planning to go Hiroshima, So ‘Okonomiyaki’[Hiroshima type] restaurant went altogether with Yamamoto Yusuke sensei.

Dr. Yamamoto Yusuke sensei, his hometown is Hiroshima. He is handsome, tall, big hearted plastic surgeon specially microsurgeon, who enjoys the toughest hepatic artery anastomosis in liver transplant pt. During eating delicious ‘Okonomiyaki’ [special order for us given by Yamamoto sensei] table discussion on Hiroshima tragedy and it’s modern fate and peace in the world. At that time Professor Sakurai told me, during 6^th august, 1945, Yamamoto sensei’s mother was 8 years old and 8 km. from main hypocenter of Atom bomb blast. She was so fortunate to survive and many people died after effect of radiation hazards of nuclear bomb. Yamamoto sensei is the illustration of his mother. He is the fortunate son of fortunate mother. I really impressed of his microsurgical technique. He is the chief plastic surgeon of Ageo central general hospital. Once a week [Tuesday] he comes to our plastic surgery dpt. and do microsurgery in transplant liver. When he is free, I enjoy talking with him about his microsurgical experiences. His microsurgical success rate is excellent. He tells me his techniques in free flap surgery and other reconstructive tactics. If I have more time to talk with him then I must be benefited. I welcome him to visit Bangladesh and share his experiences to our plastic surgeons and also his mother’s story to our children, so that our children of Bangladesh will be inspired .

I came to know about Hiroshima, Nagasaki – the Atom bomb tragedy on mankind during my childhood when I was primary school student, because our national curriculum textbook enriched with Hiroshima and Nagasaki tragedy. So I had a dream since my childhood, if I have a scope to visit Hiroshima city in Japan. I did not know I will be a plastic surgeon, but when became a plastic surgeon , miracle scope given by JBMA and Society of Plastic Surgeons of Bangladesh[SPSB]. I am thankful for their blessings.

I went to Hiroshima with Dr. Maruful Islam and spent there for two days, one day for Hiroshima and other day for Miyajima Island. This two sites of world heritage enormously impressed me. At Miyajima we enjoyed a lot. ‘O-torri’ gate, Itsukushima shrine and Mt.Misen - harmony between nature and man- made beauty.
At Hiroshima, in front of The Atom bomb dome, I conquered my dream and stood couple of minutes with silent mood. In December 1996 The A-bomb Dome was registered in the World Heritage list as a witness conveying the catastrophe of the first use of a nuclear weapon and a world peace movement appealing continually for lasting peace and the abolition of such weapons.

It was 21^st may and school holiday, I visited Hiroshima. After seeing the A-bomb Dome, there was a musical program at the river side stage performed by school girls’ and boys’. I was astonished and impressed by their instrumental melodious song. My heart was blowing with their music.

After musical program, went to in front of Children Peace Monument. This monument stands of all children who died as a result of atomic bombing of Hiroshima. The monument was originally inspired by the death of Sadako Sasaki, who was exposed to radiation from atomic bomb at the age of two. Ten years later Sadako developed leukemia. Despite the pain from her disease, she faithfully folded paper cranes in hopes of a cure. Despite the valiant effort, her brief life ended after 8 months of struggle.

Then in peace memorial museum, mushroom cloud, bomb survivors suffering from burn and other injuries, charred lunch box [bento box], student’s burned summer uniform, fire ball, catastrophic effect of nuclear bomb, keloid. Cancer etc. seen and that time I could not hold my tears. Listened and viewed recorded testimonies of A-bomb survivors. And finally I wrote my message of peace in Dialogue Notebook.

During last few days training of Dr. Maruful Islam, we visited most of beautiful sites of Tokyo. Our President of Society of Plastic surgeons Bangladesh, and National Coordinator Burn & Plastic Surgery- Professor Samanto Lal Sen sensei’s tour to Japan cancelled; because Sir was suffering acute onset of Gouty arthritis and recently developed DM. I was eagerly waiting for him to welcome in Japan. I talked to Professor Sakurai sensei about his general health condition, and Sakurai sensei directly phone call to Sen sensei to know about his physical condition. When his health status will be ok, then JBMA will arrange his visit to Japan. I think, Sir will visit after complete recovery.

In this month, I had couple of exposure to head & neck reconstruction as well as breast reconstruction. Dr. Hajime Matsumine sensei, his special interest in head& neck reconstruction. I participated with him to tongue reconstruction. I have special emphasis on head & neck reconstruction. Though the neck dissections is cribriform, but result is good because the venous pressure is low in that region. I enjoyed facial reconstruction done by Professor Sakurai sensei. I have learned some splendid techniques of flap raising as well as preparation of recipient vessels.

I saw a female pt. who had 86% flame burn, came to follow up visit and seeks advice for her axillary contracture. Surgery was performed several times. Judicial measure taken from the beginning for salvation.
Another male pt, who had also accidental flame burn in various region of his body. Within 1 year I participated several times of his surgery and now he is totally active and perform his daily activities without any hindrance.

Geometrical design and Planning is main armamentarium before flap harvesting. In every flap surgery including local, regional and free flap – precision and judiciousness that I have learned from Professor Sakurai sensei and other plastic surgeons of TWMU. I am thankful for their excellent job. The last day of this month I performed microsurgery with Professor Sakurai. It was a hand case.
Within 11 months of my training period, I have learned lot of things of plastic surgery including their culture. Very fortunate to visit Hiroshima.

I would like to thanks my parents, my respected teachers of Bangladesh, my wife, sons, relatives, friends for their encouraging support and love.

Again I am very thankful and honored by JBMA and TWMU.

New doctors in our dpt.-welcomed. Dr. Hajime Matsumine- from Harvard University Medical School, America , - good in English, comfortable for me to understand every inquiries about patient management.

Great chance to attend Fukuoka conference. Grateful to our dpt. specially Professor Sakurai sensei ,Kunimi san and always mother caring Shionori san.

My Bangladeshi colleague Dr. SK Nishat Abdullah attended Fukuoka conference. Very good time passed with him. In this conference , Professor emeritus Motohiro Nozaki sensei with us and also perforator flap specialist Professor Isao Koshima and Professor Sakurai sensei – their presence made us more convenient and fruitful. Lot of informations regarding advanced and recent trends in plastic surgery gathered. On 15 April , after conference time, me and Dr.Nishat were invited by our Bangladeshi senior brother ,Mr. Ashir ahmed, who is living in Fukuoka-shi, and also Associate Professor at Kyushu University to visit Kyushu university campus and also sea beach. Horrible experienced of earth quack near the beach area. Later we came to know that main catastrophe occurred at Kumamoto and many people died there. I pay my condolence to the people of Kumamoto.

On 17^th April I joined our pohela Boishakh [1^st bangla month] fair organized by our Bangladeshi community in Japan at Ikebukoro nishiguchi park. There was a huge gathering, Japanese people were participate and took part in singing bangla song .Our secretary General of JBMA[Bangladesh], Dr. Sheikh Aleemuzzaman Sir was the main convenor of this program.

lready I have completed 10 months of my training . Now everything is repeatedly seen by me. So I would like to request JBMA, please give some scopes to see operation in other hospitals at least once a week. So that at the last tenure of my time I want to see varieties. I would like to request JBMA, would you please arrange for me to visit dept. of plastic surgery Tokyo University.

One of our plastic surgeon from Bangladesh , Dr. Maruful Islam, Asst. Professor ,dpt.of plastic surgery Rangpur Medical College Hospital, is coming here for 3 weeks fellowship training. I welcome his Japan visit.

Finally thanks to all JBMA members.

I am thinking, how I will start to write my feedback report , because this month was very eventful for me. Day by day seems to be Japanese. May be I suppose to mix with their culture and feel the changing colours of nature in Japan. Little bit chilling throughout this month, but very comfortable. This month was fortunate for me to visit ski trip at mount Naeba, Niigata prefecture. I went to mount Naeba with some of my colleagues in our dpt. and enjoyed the beauty of ski, play snow ball throwing, onsen etc. Very amusing and fun, first life time experience. I saw a mother, who was trying to teach her baby, how to ski. I was surprised to see her baby may be hardly 2 years of old in minus degree temperature. Then I thought they are adapted such a cold weather. My mind told me this is their way to overcome the hurdles in life. I would like to thanks to our dpt. for arranging this pleasant tour.

Renowned plastic surgeon and burn care specialist, famous researcher Professor Fiona Wood from Australia, came to TWMU and delivered her lecture on Burn care medicine. She was invited by Professor Sakurai sir. And after her lecture we went to a traditional Japanese restaurant for dinner. I talked to Professor Wood and shared her knowledge on burn medicine.

CHERRY BLOOSOM( SAKURA) in Japan. A great pleasure, great time, great vibration in mind and heart. The song’ sakura sakura’ (cherry blossoms cherry bloosoms) traditional Japanese folk song depicting spring, the season of cherry blossom. I am very lucky to stay this heart blowing fascinating cherry bloosom season in Japan. In front of my hotel at Egoda, the trees that I have seen last 8 months there were almost dying leafs. All trees seem to be skeleton 8 months before, but this time every trees got back their life. Same thing almost everywhere. In our TWMU entrance road side trees are still blooming. I went to Ueno park and also Naka Meguro to see cherry bloosom(Hanami). Thousands of people, tourist enjoyed Hanami. At day time went to Ueno and night time to Naka Meguro. Two different observations and feelings. Both were splendid. I particularly enjoyed the bloosoms at dusk when lanterns hang in the trees, turning the canopy a glowing pink. So lot of significance in Hanami. Memory chips set in my mind.

This month I performed as like as almost same type of operations of previous month.

This month I have to loss 4 of my colleagues ,who are going to join another hospital for shifting. Last 8 months I have passed good time with their smiling cooperation. Dr. Hishiyama, Dr. Yuki Hasegawa, Dr. Kirita, Dr. Ikeda-- miss all of you. I will never forget their friendly cooperation. I always hope and pray their excellent academic career and prosperous life.

And finally I thank all JBMA members.

When I sit to write this report, it is 1st week of March. The intensity of cold is decreasing and bringing the spring season that is most joyful time, especially in Japan –has a great significance. I am waiting for the best season of Japan; where nature spread its fragrance to every sphere of atmosphere. I am hungry to enjoy the changing colors of nature. In Bangladesh there are six seasons- summer, rainy, autumn, late autumn, winter, spring. Among spring is the king of season. But nowadays season time and its beauty are changing due to global warming. Especially in spring time my heart become to start dancing, because nature looks bright and charming. Trees and plants put on new leaves and twigs, countless varieties of flowers bloom and make the whole atmosphere delightful with their sweet fragrance; birds are happy and pour out their melodious songs which thrill the heart of all. So I am eagerly waiting colorful spring in Japan.

On 24^th February there was an invitation dinner at SHINJUKU luxurious restaurant – on behalf of JBMA President Professor emeritus Motohiro Nozaki sensei. I would like to give my utmost respect and thanks on behalf of two Bangladeshi trainees at TWMUH to all members of JBMA for their take care and strengthening our training program. At this program, Dr. Mahfuz met first time with Nozaki sensei. A great time passed as well as delicious dinner with President of JBMA, also Professor Hiroyuki Sakurai, Professor Masaki Takeuchi, Assist.Professor Dr. Hiroshi Ito, Dr. Hishiyama, Dr. Niimi, Secretary of JBMA Ms. Izumi Iwata and secretary to Professor Sakurai sensei Ms. Maiko kunimi.

This month I assisted the operations- DIEAP flap for breast reconstruction, Micro-skin graft for vitiligo, Free SIEA flap for correction of post burn scar contracture of foot, Contralateral superficial temporal artery free flap for reconstruction of post burn alopecia over left temple region, Distal bypass surgery with free LD flap for peripheral vascular disease of foot, Free LD flap coverage for radio-necrosis of right clavicle and precarious skin, STSG, Palatoplasty, Blepharoplasty etc.

Recently ‘TREE MAN’ of Bangladesh named Mr. Abul Bajandar has noticed the International Media. Later he was sent to NIBPS Dhaka. A plastic surgery team headed by Professor Md. Abul Kalam, did the surgery of tree man and took step wise management for his rehabilitation.

Few days ago, Professor Sakurai sensei told me about next trainee of plastic surgery and also they are planning to invite our President and Secretary General of Society of Plastic Surgeons Bangladesh [SPSB] in Japan.

I would like to express my thankful gratitude to JBMA for requesting Dr. S L Sen sir and Professor Dr. Md. Abul Kalam sir to visit Japan and share their experiences.

Starting the New Year in Japan, there is almost 7 days holiday. This time most of the people visit their home town to meet their relatives and also New Year praying for smooth and fortunate life. So I had at least 7 days holiday. I was thinking, how I shall have to enjoy and utilize my time. I made a plan to visit Mount-Takaosan.

1^st January 2016 went to Mount Takao near Tokyo, just feelings the gift of nature. Almost same enjoyment and feelings in my country at Bandarban (chimbuk and nilgiri) and Khagrachori- the two mountain site in Bangladesh. At the peak of Mount Takao, I enjoyed beautiful scenery and also put my eyes to Mount Fuji and catch the glimpse of beauty.

On 18^th January when I wake up very early morning and ready to go hospital, still this time I could not think what about the outside. But when I just outside my room, everything changed. I stopped for few moments, and became surprise that everything was white. Then I realized its snow fall. My heart was dancing with joy. First time seen the snow fall. I took photograph and video and preserve in my album. This became a memorable event in my life and first experience is always a great one.

On 29^th January I had received my Bangladeshi colleague Dr. Mahfuz (who will be training in urology dpt.TWMU) from Haneda int. airport, Tokyo and then by taxi we reached our Flexstay-Inn-Ekota, after taking rest we went to Indian restaurant for dinner. Everything was smooth and very comfortable, before that JBMA arranged convenience for receiving Dr.Mahfuz from Haneda airport.

This year journey started with free flap surgery. It was free LD flap for scalp bone and soft tissue defect. I also joined free SCIA, free ALT, free auricular helix flap, nipple reconstruction, scar revision, cleft surgery, hand surgery etc.
Plastic surgery is a subject without any boundary, deals top of the head to tip of the toes. So at this stage of my training I feel if I could have the opportunity to visit some specialized plastic surgical centers like Head-Neck Cranio-Facial center, Aesthetic surgery, Hand surgery 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 peaceful and prosperous year ahead of us who are concerned with JBMA.

I have successfully completed half of my training time in Japan when I sit to write this report. Thanks to Almighty ALLAH for keeping me in good health and mind. Now it is full winter season in Tokyo, but still no sign of snow fall. In last six months I came to learn many of Japanese culture and customs besides my academic activities.

As it was last month of 2015, so that very significant dimensions in my training experience as well as cultural participation and when I came to know from our President Dr. S.L.Sen sir and Secretary General Professor Dr. Md. Abul Kalam sir, of Society of Plastic Surgeons of Bangladesh (SPSB), that our Govt. approved and sanctioned in ECNEC meeting to run in full swing the development of NIBPS (National Institute of Burn and Plastic Surgery). I would like to thanks to Dr. S.L.Sen sir, not only his outstanding achievement for NIBPS establishment but also arranged this scholarship training program in TWMU of Japan by JBMA.

On 2^nd December I went to Edogawa hospital with Professor Sakurai sensei. Sir drove his car and we discussed many matters during our journey to Edogawa hospital and there performed a post mastectomy breast reconstruction.

On 4^th December, there was a great surprise for me when Kunimi san requested me to come to Professor’s room. When I entered Professor’s room, then Sakurai sensei handed over me a nice gift on behalf of President of JBMA, Professor emeritus Motohiro Nozaki sensei. I would like to thanks to Nozaki sensei for his splendid gift. I opened the box, and it was a UNIQLO brand’s good quality heat –tech winter protection jacket.

It was first time experience of my life to attend the ‘Bonen Kai’ (year-end) party of dpt. of plastic and reconstructive surgery, TWMU; that was held at Rihga Royal hotel, Tokyo on 10th December. When I reached the hotel lobby, first I met President of JBMA Professor Motohiro Nozaki sir and conveyed my acknowledgement and special thanks for his gift. At the beginning of Bonen Kai program, Professor Sakurai sir delivered his speech and again introduced me among the guests. Professor Hirayama sensei, Professor Motohiro Nozaki sensei and other distinguished guest had their speech about Bonen -Kai party. I was really surprised and overwhelmed of my colleagues when they were dancing in background music, only wearing undergarments on stage, in front of guests. It is quite impossible in my country in front of eminent professors. I enjoyed so much and after finishing the party we all joined the Bonen Kai dinner at Takadanobaba. I will never forget this amusement of ‘Bonen Kai'.

On 14^th December, Secretary General of JBMA Bangladesh, Dr.Sheikh Aleemuzzaman sir invited me to come his Tokyo house for attending dinner with other Bangladeshi doctors. I went to his house and his wife Dr.Noriko Kinukawa madam cooked delicious Bangladeshi food. A visiting team led by Professor Dr.Salahuddin Al Azad, chairman, dpt. of Radiology and Imaging, BSMMU was also invited.

The 16^th December was our 44^th national victory day. I was invited to 44^th victory day celebration program on 20th December, arranged by Bangladeshi Community in Japan at Akabane. Ambassador of Bangladesh in Japan, Dr. Jiban Ranjan Mojumder was present there as a chief guest. Discussions on victory day ,recitations, victory song and finally hospitality by Bangladeshi food like white rice, beef bhuna, potato votta, fish votta, chicken roast. Sweets etc.

In this month, free thoracodorsal artery flap for reconstruction of mandibular defect, free ALT for soft tissue and bone defect of head, facial nerve palsy correction with sural nerve graft, expander insertion in face, neck, chest for correction of cheek contracture, varicose vein surgery, cleft surgery, breast expander insertion etc. performed.

On 28^th December, there was another year end party named ‘ Mesu Osame kai’ which means end of all operations of the year. I think ‘Bonen kai’ and ‘Mesu Osame kai’ these parties are excellent concept and I feel the lack of such celebrations in my country, which really augments the spirit of dedication to work.

At the end I would like to wish everyone concerned with Japan Bangladesh Medical Association a very happy new year. Happy 2016.........

In this month climate is becoming to change and making declaration to winter season. Already I have got my clinical advanced license in October. This November, there was a farewell program of Professor Kikuchi sensei, who had been working in this department. since last 30 years. He is very popular for funnel chest operation. From the very beginning of my advanced training, assisted with him a good number of funnel chest operation and also one case of microtia reconstruction. He did funnel chest operation very synchronize and rhythmical way, although funnel chest deformity is less common in my country but I enjoyed. In this farewell program, Professor Sakurai sensei including all senior teachers had speech and expressed their views about his contribution to plastic surgery in TWMU.

In 2^nd week of this month, Professor Masaki Takeuchi came to ikyoku for official purpose. He invited me to go Yachiyo Medical Center for managing a sternal dehiscence patient. I willingly agreed to go there in next day. Next day I went to Yachiyo Medical Center and met Professor Takeuchi sensei and other doctors of plastic surgery dpt. ‘Yachiyo’ Medical Center is a very neat and clean hospital. I did assist a pectoralis major muscle flap coverage for sternal dehiscence of that patient and also correction of aged ptosis of another patient. with him. After completion of operation, I and Professor Takeuchi sensei came back to TWMU for joining the department’s meeting. I learned in this operation how much adequate controlled wound debridement and also simultaneous water irrigation was needed for satisfactory coverage.

Last week of this month, I attended the 42nd Annual Meeting of the Japanese Society for Reconstructive Microsurgery at Rafre-Saitama. This opportunity came when I became to know from my colleagues and I expressed my inclination to Professor Sakurai sensei to attend Saitama conference. He agreed my proposal and recommended me to attend this conference. At first day of Saitama meeting, the weather was very cold, first time I experienced, ‘what is cold’. In this conference I was really overwhelmed to see huge number of reconstructive microsurgeons. I attended the two visiting professor’s lecture, one was from Korea and another was from Taiwan. I have gained lot of information from their lecture. Although most of the sessions were Japanese language but I understand the slides. I had also visited the exhibition of microsurgical instruments, operating microscope, eye loupes etc. in conference premises. In this two days conference I met senior and young reconstructive microsurgeons. Professor Yoshikazu Ikuta from Hiroshima, who was the president of 3rd Annual Meeting of the Japanese Society for Reconstructive Microsurgery, we sat together at lobby during lunch and Yamamoto sensei introduced me to him. During taking lunch, we talked each other and shared lot of things. In Saitama conference, I gained magnitude of experiences.

This month I joined the operation of free radial forearm flap coverage for defect of nose after excision of haemangiomatous tissue, after mastectomy immediate breast reconstruction by LD pedicle flap, reconstruction of facial bone fractures, nipple reconstruction, varicose vein surgery, cleft surgery, palatal fistula repair, autologous diced cartilage transplant for rhinoplasty, correction of craniosynostosis, scar revision, ptosis, entropion, nasal bone fracture etc.

This month of October was more challenging for me specially because of attending ‘SHINJUKU FORUM’ at Rihga Royal Hotel, Tokyo and presented my topic ‘Burn and Plastic surgical activities in Bangladesh and its future’. His excellency Dr. Kunio SAIKI was present there as a chief guest. I was very pleased and delighted to see all plastic surgeons of Japan in this program and end of program I talked to Dr. Kunio SAIKI about my mission and vision in TWMU. He advised me a lot and a message that I took in my heart was ‘KOKOROZASHI’. I also discussed various topics with young plastic surgeons of different hospitals. After that there was a mouthwatering and dinner party.

This month I met with senior most plastic surgeon Professor Takeshi Hirayama at Ikyoku. He would like to know about Professor A.Z.M. Salek and also his trainees Dr. Ashraf, Dr. Sarower. I conveyed their greetings to him.

3 free flaps surgery done in this month. I attended and assisted every surgery and learnt how monitoring tools and timely intervention helped the successful outcome.

One case of SIEA flap applied over exposed dorsal tendons of left hand of a female patient. But 1st POD the flap margin was dusky and monitoring catheter site venous pressure was exceeded beyond its normal range. And we performed again exploration of this site and found venous thrombosis at the coaptation site. So, reanastomosis on more proximal venous site and ensured important venous blood parameters for final checking of flap and also venous catheter was placed for venous monitoring.

Other operation includes pectus bar insertion for funnel chest, breast reforming with nippleplasty, congenital syndactly, breast implant insertion, coverage of exposed dura by free ALT flap, craniosynostosis, orbital floor fracture, maxilla and mandible fracture reconstruction, nasal bone fracture, baggy eye correction etc.

Last week of this month, I went to Ueno Park and enjoyed the laser display in front of National Museum of Nature and Science and also attended a cultural program which was in open air music and aristocratic dance show in front of Tokyo National Museum combined with various glistening colourful fountains, impressed me.

I am going to be acquainted with everything and run in first track like a racing car. First week of this month 65 years old patient, was admitted in plastic surgery dpt. with diabetic foot ulcer over right 5^th metatarsal area. Professor Sakurai sensei examined him in detail and decided to make a special reconstructive protocol regarding diabetic foot ulcer management. Before this most of the diabetic foot ulcer cases done amputation of this part. Vascular surgeon was invited to this hospital and operation was done. Distal limb bypass surgery for revascularization as well as free LD and scapular bone flap for defect part for hope of walking. It was very interesting and enthusiastic for me. During follow up period special monitoring system and regular visit of this patient made successful outcome of reconstruction and later patient was discharged from hospital with confidence and smile.

In the second week, another facial reconstruction by free flap (free LD+Seratus anterior muscle+bone graft) done. Prefabrication of one flap for ensuring more vascularity because previously patient had it maxillectomy followed by chemo-radiation for malignant growth. This innovative tactics and technique made me more impress and enthusiast.

Last week of this month, came to a great message for me, when Sakurai sensei told me to go another hospital (Tama medical center) for esophageal reconstruction by free jejunal flap. I was very much impressed and enjoyed to assist with him. Before this I read only in my plastic surgery books about this operation. So I achieved the latest advanced surgery. Still this type of surgery not practiced in my country. After returning to my country I will be the next to start this surgery in my country.

Besides these, congenital chest deformity, facial bone fracture, Breast reconstruction(both implant and DIEA flap), nasal tip and orifice reconstruction, varieties of scar management, varicose vein surgery, soft tissue tumor removal, venous malformation, pressure sore, cleft surgery, eye lid reconstruction, STSG. etc. In outpatient clinic, I have seen varieties of patients and laser treatment of different skin lesions.

The 24^th September was our biggest festive day, EID-UL-ADHA. The first time I was outside from my family. I went to Ueno-okachimachi mosque early morning with special festive dress and after end of prayer, I embraced with different Muslim country’s people and also my some Bangladeshi brothers. Then I went to with our BD brother’s home and ate special eid menu like polao, biryani, sweets etc. and sent eid greetings to my family, relatives, friends and others.

The next day again return to my first track. I have to be busy all day long, so I get little scope to go sightseeing. In holiday, most of time I spend in my room with cooking, watching TV (Sumo wrestling, drama), communicate with my friends and family members and afternoon I go to play field and enjoy baseball, football. Sometimes I go to market place and Nihon University College of Arts.

Japan is a country of symbol of etiquette and manner; I heard and learned from my primary school level when I was 10 years of age. There was a little bit idea of Japanese culture in our primary level in national curriculum textbook. In my early hood I have seen ‘OSHIN’-the drama serial in our Bangladeshi television. From there I came to know the inception of Japanese culture, they are polite, gentle and hard worker; and this drama the actress ‘OSHIN’ really impressed me and still today I could not forget her name.

After long time, I became the part of opportunity for my advance plastic & reconstructive surgery training program in TWMU and to taste the culture of Japan. This privilege that I have gotten by JBMA. My Professor Dr.Md. Abul Kalam selected me among the Bangladeshi plastic surgeons and sent a letter to Professor Hiroyuki Sakurai sensei. Professor Sakurai sensei sent acceptance letter along with all official documents by mail. Ms. Fumiko Daikoku from int. students section of TWMU time to time sent me necessary information regarding training program. Ms. Maiko Kunimi always made everything clear and palatable. But on the other hand, I could not prepare myself necessary documents in proper time due to some government procedure. As a government officer in Bangladesh, I had to get govt. sanction of leave and permission from ministry of health in Bangladesh, which was a lengthy procedure. But when I got permission and G.O. from my government, my beloved father suddenly attacked of myocardial infarction, which felt me bolt from the blue. Then I sent a mail to Professor Sakurai sensei and cordially convey message about my situation. He advised me ‘Take care your father first, and after complete recovery then you come’. My father is blessed with his prayers.

I reached Haneda airport Tokyo in 26^th July. Respected teacher Professor Hiroyuki Sakurai sensei and assistant professor Hiroshi Itoh sensei, received me at the airport. I was impressed to see both of them at airport. Then they took me in his car and drove me to my apartment followed by welcome dinner at a traditional Japanese restaurant. Itoh sensei helped me to open up my laptop with Wi-Fi connection in my room to convey message for safe arrival in Japan to my family.

Tokyo is being totally unknown to me; but patience guideline by Ms. Maiko Kunimi, who showed me streets, subways and made me acquainted. Ms. Yumiko Shionori (always smiling) kept me confident and accustomed.

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

The food, as expected became difficult for me due to my poor acquaintance with Japanese food and being apprentice in cooking. So I had to spend my time and stamina in cooking and kept me awaken till midnight. As a result I had to remain little bit drowsy in operation room.

A few days after my joining at TWMU, a great opportunity came to me for enjoy a river cruise along with Hanabi show by the courtesy of Professor emeritus Motohiro Nozaki sensei. I was fortunate to enjoy most attractive event. Later a special dinner party on behalf of Professor Motohiro Nozaki sensei, I met with respected living legend. He kept his hand on my shoulder and it was blessings for my future career.

Finally, I would like to give my honor and special thanks to my mentor Professor Hiroyuki Sakurai sensei and also JBMA, as I realize that this scholarship will not only enrich my knowledge and experiences but also open the door of views and sharing of experiences between Japan and Bangladesh.

However, Tokyo Women’s Medical University is an overwhelming experience for me. The friendly attitude of all senior and junior colleagues of plastic and reconstructive surgery dpt. as well as administrative staffs and splendid cooperation of anesthesiologist and nursing staffs as well as modern OT environment was really impressed me. I have seen the surgical ethics, I have seen the doctors-patient relationship, and I have seen how kind and work worth fully for mankind be.