The purpose of this study was to assess vascularity of the lunate by number of foramina and radiography of vessels of the wrist. The genesis of lunatomalacia requires some vascular risk and mechanical predisposition. The findings were correlated with the cause of Kienböck's disease. The vascular foramina were more than two in 91.33% of the lunate. The lunate had consistent dorsal and palmar branches from radial artery. The additional branches from anterior interosseous artery in 72.22% and a branch of palmar inter carpal arch in 69.44% cases contributed in arterial anastomosis on palmar aspect of lunate. The dorsal blood supply was found by anterior interosseous artery in 85.71% of specimens and dorsal branch from dorsal intercarpal arch in 50% of specimens. The blood supply of lunate comes along with various ligaments which may be disrupted due to trauma or strain leading to avascular necrosis. The present observations are suggestive of rich blood supply of lunate in comparison of other investigations. Therefore Kienböck's disease is less common in northern India.

Purpose: Early detection of ovarian malignancy is of great clinical importance. The high mortality rate is due to the difficulties with the early detection of ovarian cancer. Current research attempted to assess the accuracy of Color Doppler Sonography and serum CA-125 level as diagnostic tool of ovarian tumor. Materials and Methods: In this cross-sectional study, 60 consecutive patients with ovarian tumor attending the Department of Obstetrics and Gynecology of BSMMU were recruited. Of the study participants 23.3% belong to 16-25 year age group, 20% belong to 26-35 years age group and 23.30% each were of 46-55 years and > 55 years age group. All the patients recruited were from in-patient department and had undergone surgery. Following excision, routine histopathology revealed 43.30% malignant (n=26) and 56.7% (n=34) benign ovarian lesion. Data were collected from the clinical history form and bimanual pelvic examination, serum CA 125 levels, estimation of Resistance index (RI), Pulsatility Index (PI), Novel Index by CDS and post-operative histo-pathological findings were then recorded. Sensitivity, specificity, accuracy, positive and negative predictive value of the diagnosis made by CDS, CA125, in the discrimination of the benign and malignant ovarian tumors was calculated. Using Receiver operative characteristics analysis the accuracy of RI, PI, CA 125 and Novel Index in the diagnosis of ovarian tumor (benign or malignant) were assessed. Results: With the Cut-off of <.5, Resistance Index is found to be capable of detecting 92% of malignant cases (sensitivity 91.7), and could detect 89% (specificity 88.9) of benign cases correctly which translates in to 90% accuracy in the diagnosis of ovarian tumor. Predictive values for positive (84.6) and negative (94.1) tests were also found to be quite high. Pulsatility index was found to be moderate accuracy (63.3%) with cutoff <1 for malignancy, however low predictive value for a positive test (38.5) questions its use. Both CA-125 and Novel Index showed similar level of sensitivity and specificity. Although Novel Index is derivative of CA125, Novel Index demonstrated better diagnostic accuracy and negative predictive value. The cutoff for CA 125 was mandated as 83.58. With the value the sensitivity is 76.9% and the specificity is 94.1%. RI is found to be more sensitive in detection of positive cases (Malignant) and CA125 is found to be more accurate in detection of negative cases (Benign). However a combination could be tried to make a better detection. Conclusion: Color Doppler ultra-sonography and CA125 excels in different tasks, the study concludes in favor of concurrent use of the methods for improving efficacy and thus early detection of ovarian malignancy.

The yolk sac is the first extra embryonic structure that becomes sonographically visible within the gestational sac and acts as the primary route of exchange between the human embryo and the mother before the placental circulation is established. The yolk sac is a round structure that is made up of an anechoic center bordered by a regular well-defined echogenic rim. It is usually 2-5 mm in diameter. The yolk sac appears at 6 weeks, thereafter increases in size, attains its maximum diameter at 10 weeks and then it starts decreasing in size. It disappears at 12 weeks. Aims and Objectives of the present study is to measure the size of yolk sac in pregnancies of duration 6-12 weeks by Transvaginal sonography and also to measure the inner diameter of yolk sac and correlate it with pregnancy outcome. Materials and Methods: We studied 72 pregnant women of duration 6-12 weeks referred by Department of Obstetrics and Gynaecology. The inner diameter of yolk sac was measured by Transvaginal sonography and its correlation with pregnancy outcome was studied. Observations and Results: The mean yolk sac diameter was noted as 3.7±1.8 mm. The diameter of the smallest yolk sac was 1.25 mm and that of the largest was 8.96 mm. Yolk sac size was normal in 62 (88.57%) cases, it was smaller in size in one (1.4%) case. Further in another 7 (10%) cases, the yolk sac was found to be abnormally enlarged. In these cases where yolk sac was either enlarged or smaller in size, gestation terminated into abortion.

This prospective interventional study was carried out on 40 intrapartum jaundice patients admitted in the Department of Obstetrics and Gynaecology, Dhaka Medical College Hospital during January to December 2004. The purpose of the study was to evaluate the effectiveness of prophylactic intrauterine hydrostatic balloon/condom temponade in addition to other conventional methods to prevent and control postpartum haemorrhage in patients with jaundice, to detect the prevalence of different etiological agents responsible for jaundice and to assess the foeto-maternal outcome in this study group. Prophylactic intrauterine hydrostatic balloon temponade was inserted in all of the 40 cases which showed an excellent effectiveness in preventing postpartum haemorrhage in patients with jaundice. The study also showed increased prevalence of Hepatitis E virus (HEV) and a high proportion of perinatal deaths in the study population. DOI: 10.3329/jbcps.v26i1.4229 J Bangladesh Coll Phys Surg 2008; 26: 22-25

Broad ligament pregnancy is a rare obstetric condition. Its diagnosis is quite difficult andmanagement is challenging. Here we report a case of a 26 years old primi gravida conceivedfollowing laparoscopy and ovulation induction. Diagnosis of the broad ligament pregnancywas done by a transvaginal ultrasound at her 9 weeks and was proceded with laparoscopyfollowed by laparotomy. A right broad ligament pregnancy was found and the sac with fetuswas removed. Laparoscopy was converted into a laparotomy as there was an uncontrollablebleeding from the broad ligament. Here we present a case of this extreme rare type of broadligament pregnancy. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 164-166