Background: Tracheal intubation in oro-maxillofacial surgery is an important issue during operation. Objective: The purpose of the present study was to demonstrate the feasibility and the reliability of submandibular tracheal intubation as an alternative method for airway management in oro-maxillofacial surgery. Methodology: This clinical trial was conducted in the Department of oromaxillofacial Surgery at Dhaka Dental College and Hospital, Dhaka from January 2010 to June 2011 for a period of one and half year. Patients suffering from painful fractures associated with displaced nasal fracture were selected as study population. Results: A total number of 9 patients were recruited for this study of which 1 was female and 8 were males and the age range was between 16 to 51 years. The technique was found easy and offers a secure airway to the anaesthetist, an optimal operating field and an opportunity to check the dental occlusion with limited morbidity for the patient. In all patients the submandibular tracheal tube was extubated after the operation without complications or difficulties. Accidental dislodgement of the tube to the right main bronchus occurred in one patient while carrying out the procedure. It was rapidly detected and corrected. No other complications were encountered. Conclusion: Submandibular tracheal intubation is a safe, simple and effective technique for upper airway management when both oral and nasal tracheal intubations are not convenient in some oromaxillofacial surgery. [Journal of National Institute of Neurosciences Bangladesh, 2015;1(2): 41-46]

Structured training had no impact on overall PPIUD insertion rate. However, it did impact numbers of women receiving counselling, perceived quality of the counselling received, and overall removal rates.

Background: Postpartum haemorrhage (PPH) is a major cause of maternal mortality,accounting for one-quarter of all maternal deaths worldwide. Tranexamic acid (TXA), anantifibrinolytic agent, has therefore been investigated as a potentially useful complement toprevention and treatment of PPH. It has been proved to reduce blood loss in elective surgery,bleeding in trauma patients, and menstrual blood loss. Aims: To evaluate the effectiveness of TXA in reducing blood loss given just immediatelyafter delivery of baby in women undergoing cesarean section. Methods: This was a prospective, randomized, double blind, placebo controlled studyconducted in the Department of Gynaecology and Obstetrics unit of IBN SINA Medical CollegeDhaka, Bangladesh from June 2016 to May 2017. Participants were randomly assigned toTXA group or group A (n=60) and placebo group or group B (n=60). Randomization wasdone by residents using computer generated random numbers. Group A received 1 gram(10ml) of intravenous bolus dose of TXA just after delivery of the baby, Group B received 10ml of sterile distilled water for injection intravenously at the same time. Statistical analysishas been done by SPSS. Results: The subjective characteristics in the two groups were similar with respect to theirage, BMI, gestational age and gravidity. The duration of surgery was 40-50 minutes. Therewas no statistically significant difference in the heart rates (p>0.05) and blood pressuresbetween the two groups, after 2 hours of delivery. Blood losses from both placental deliveriesto the end of cesarean section and from end of CS to 2 hours postpartum were significantlylower in the study group (p<0.05). Change in hemoglobin concentration in study group wasalso significantly less than in the control group. Total amount of oxytocin required wassignificantly less in TXA group (p<0.05) also the number of women requiring other oxytocics(inj. Methyl ergometrine, inj carboprost and tab misoprostol per rectally) was significantlyless in TXA group (p< 0.05). The amount of intra-operative fluid required were significantlyless in TXA group (p<0.005); however post – operative fluid requirement and minor sideeffects in the form of nausea and vomiting were similar in both the groups. Conclusion: Tranexamic acid can effectively reduce blood loss in patients undergoing LSCSand its use was not associated with any side effects and or complications like thrombosis.The adoption of WHO guidelines for using uterotonic agents and prophylactically administeringTXA may significantly reduce the number of PPH incidents. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 125-130

Worldwide intra uterine contraceptive device (IUCD) is a reversible method of contraception. Postpartum IUCD insertion is labeled when IUCD is inserted within 10 minutes to 48 hours of expulsion of placenta. The objective of the study was to analyze the acceptability and feasibility of immediate postpartum intrauterine contraceptive device (PPIUCD) in a tertiary care hospital of Bangladesh. A cross sectional study was conducted among eligible postpartum women at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka Bangladesh. Counseling was done about the procedure of PPIUCD in details. After having the consent, Cu-T 380A was inserted in 343 women. The women were followed up at six weeks after delivery. A total number of 18190 women were counseled during antenatal period and at labor ward. A total number of 6441 were admitted for delivery. Among the admitted patients, 343 accepted this method. Forty nine percent of the acceptors belonged to the age group of 25 – 30 years. Majority  were from urban area and had studied up to secondary level. More women from the group who had undergone caesarean section accepted this method than the women who undergone vaginal delivery. Expulsion rate was 1.6% and removal rate 5.8%. Most common reason for removal was irregular per vaginal bleeding. The immediate PPIUCD method appeared to be a safe and effective method of contraception. Bangladesh Med J. 2018 Jan; 47 (3): 25-31

Introduction:Cesarean section (CS) is the most common obstetric operation carried out in daily obstetric practice and the incidence has shown a dramatic increase over the last few decades globally. 1 With the improvement of operative technologies, anaesthia coverage and blood transfusion facilities, safety of cesarean section has increased considerably. Still it is a major operation and is associated with certain risks and complications.Complications rate associated with cesarean section is known to be several fold than that of vaginal deliveries. 2,3 This may be due in part to the pathology underlying the indication for the operation or the quality of surgery.In some cases, the complications mandates a repeat laparotomy -(Relaparotomy) requiring the patient to return to the operating theater. Most of the time, relaparotomy is performed when the conditions of Original Articles

<p>The aim of this study was to find out the effects of raised serum uric acid level on perinatal and maternal outcome in cases of pregnancy-induced hypertension. One hundred pregnant women with gestational period beyond 28 weeks with pregnancy-induced hypertension-preeclampsia and eclampsia were included in this study and divided into two groups. Group A (n=65) patients with a serum uric acid level &gt;6 mg/dL was compared to Group B (n=35) patients with a uric acid level &lt;6 gm/dL. It revealed that high uric acid level in patients with pregnancy-induced hypertension was a risk factor for several maternal complications like postpartum hemorrhage (Group A, 17.4%; Group B, 22.6%), postpartum eclampsia (Group A, 10.1%; Group B, 9.7%), abruptio placentae (Group A, 8.7%; Group B, 6.4%), HELLP syndrome (Group A, 2.9%; Group B, 0%) and pulmonary edema (Group A, 4.3%; Group B, 0%). In case of perinatal outcome, the birth weight, intrauterine growth retardation, intrauterine death, stillbirth and neonatal death rate were worse in Group A 1.9 kg, 66.7, 19, 7 and 8% in comparison to Group B, where those were 2.1, 13, 6, 2, and 2% respectively. In conclusion, high uric acid in blood in patient with hypertensive disorders in pregnancy is a risk factor for several maternal complications.</p>

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Objective: To evaluate whether there is any association of Toxoplasma gondii infection with spontaneous abortion.Materials and Methods: This observational case control study was conducted in the Department of Obstetrics and Gynaecology, Dhaka Medical College Hospital, Dhaka (DMCH), over a period of one year from 31st December 2008 to 30th November 2009. A total 91 pregnant women were selected for this study. Among them 46 patients of spontaneous abortion were selected as case and 45 healthy pregnant women were selected as control purposively. Spontaneous abortion cases were diagnosed on the basis of history, clinical examination and USG findings. Patients with medical disorder, Rh-incompatibility, multiple pregnancy, cervical incompetence, septic abortion, threatened abortion, fibroid with pregnancy and uterine anomaly were excluded from the study. The clinical examination was done by standard method. Blood was collected from each subject, serum was separated. Main outcome measure was presence of toxoplasma antibodies in spontaneous abortion cases. Antibody was detected by ELISA method. A p value of <0.5 was considered as significant.Results: In both groups there was no difference in age, gestational age, socioeconomic status, living standard and educational status. Toxoplasma specific IgM was detected in higher percentage of women with spontaneous abortion (15.2%) than with controls (0%), which is statistically significant (<0.05). Seroprevalence for past Toxoplasma infection (IgG) was similar in both the groups, 17.4% and 8.9% for case and control respectively (p>0.05). Though there is no association between seropositivity and level of education, place of living, contact with cat, occupational status, parity and past history of spontaneous abortion, seropositivity is higher in the poor socioeconomic group.Conclusion: Seroprevalence for recent Toxoplasma gondii infection is higher in women with spontaneous abortion.Bangladesh J Obstet Gynaecol, 2014; Vol. 29(2) : 87-93