PURPOSE The aim of the study was to evaluate the efficacy of hysterectomy in the control of pelvic disease in patients with post-irradiated residual cervical cancer. PATIENTS AND METHODS Forty patients were treated at either National Institute of Cancer Research and Hospital (NICRH) or Delta Cancer Hospital in Dhaka, Bangladesh, with International Federation of Gynecology and Obstetrics stage IIB to IIIB disease with residual disease after the following: either concurrent chemoradiation with or without brachytherapy, induction chemotherapy and external-beam radiotherapy (EBRT) with or without brachytherapy, or only EBRT. Patients were treated by either radical hysterectomy or extrafascial hysterectomy. RESULTS From 2009 to June 2013, 55 patients were evaluated for central residual disease on their presentations to NICRH or Delta Hospital. Patients with distant recurrences after primary radiation were excluded. Forty patients had invasive cancer on biopsy and underwent either radical hysterectomy or extrafascial hysterectomy. Surgery was performed 14 to 18 weeks after the initial treatment. Of the 29 women who underwent extrafascial hysterectomy, four (13.8%) developed recurrent disease, and one died; none of the 11 patients treated by radical hysterectomy experienced recurrences during the study period. Morbidity was increased in patients who underwent radical hysterectomy. Overall 90% of patients (36 of 40 patients) who underwent surgery had no evidence of disease at 5 years of follow-up. CONCLUSION Surgery is a viable treatment option for patients with residual cervical cancer after radiation. Radical hysterectomy after radiation is more morbid but has better tumor control than extrafascial hysterectomy.

Objective: This cross sectional study was conducted in the dept. of clinical pathology in collaboration with dept. of cardiology, Bangabandhu Sheikh Mujib Medical University (BSMMU) and Bangladesh Institute of Research & Rehabilitation of Diabetes Endocrine and Metabolic Disorders (BIRDEM) to evaluate the role of platelet distribution width (PDW) in diagnosing acute coronary syndrome (ACS). Patients & Methods: A total of 142 patients were selected for the study. Of them 79 were cases (patients with acute coronary syndrome) and 63 were controls (patients with non cardiac chest pain). The cardiologist established the diagnosis by clinical examination, ECG and biochemical markers especially troponin I. A structured questionnaire was used which addressed all the variables of interest. Blood samples of the selected patients were taken to investigate their platelet distribution width level and to find its association with ACS. The blood samples was taken properly and processed in a Haematology auto analyzer within 2 hours of collection, which again rechecked manually by peripheral blood film. Statistical analyses were done using mean± standard deviation (SD), t-test, Chi-square (x2) with 95% confidence interval. Test of validity done by receiver operative characteristic curves.Result: In the present study, platelet counts were 273.1±50.15 x 109/L in patients with ACS and 290.78±74.86 x 109/L in control subjects. Platelet counts were slightly low in patients with ACS compared to control subjects. There were no statistical significant differences between the groups in unpaired t- tests. MPV was 12.48±1.17 fl and 10.45±0.66 fl in patients with ACS and control subjects. PDW was 16.23±2.56 fl and 11.89±1.42 fl in patients with ACS and control subjects. Both MPV and PDW were statistically significant between the groups (P<0.001) in unpaired t-test. Patients with acute coronary syndrome the sensitivity, specificity, positive predictive value and negative predictive value of platelet counts, MPV and PDW were obtained by ROC curve and compared with control subjects. The best cut off value of platelet count, MPV & PDW were >225 x 109/L, > 10.7 fl and >12.7 fl respectively. The sensitivity, specificity, accuracy, positive and negative predictive value of platelet counts, MPV and PDW were 83%, 28.1%, 42.3%, 37.6%, 64%; 90.6%, 49.4%, 64.8%, 51.6%, 89.8%; and 94.3%,52.8%, 69%,54.9%, 94.1% respectively. In our study, we found that PDW had higher sensitivity and specificity in contrast to MPV. These PDW are used as predictor for early detection of ACS and risk stratification when other cardiac biomarkers are negative.Conclusion: The PDW is an early indicator to diagnose ACS and correlates with the prognosis of ACS. DOI: http://dx.doi.org/10.3329/uhj.v9i1.19430 University Heart Journal Vol. 9, No. 1, January 2013; 3-8

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83%, 28.1%, 42.3%, 37.6%, 64% and 90.6%, 49.4%, 64.8%, 51.6%, 89.8% respectively. In our study, we found that MPV had higher sensitivity and specificity in contrast to platelet count. MPV may used as predictor for early detection of ACS and risk stratification when other cardiac biomarkers are negative.

Background: Post caesarean section (CS) wound infection or surgical site infection is a leading cause of prolonged hospital stay or readmission. An understanding of its risk factors is important. Methods: A case control study was conducted in the Department of Obstetrics and Gynecology of Sir Salimullah Medical College & Mitford Hospital, in Dhaka, Bangladesh from January to June 2014 to evaluate the risk factors of postoperative surgical site infection following CS. One hundred patients were studied. Results: Fifty patients of post CS wound infection (surgical site infection: SSI) were selected as cases. Body mass index > 25 (kg/m 2), anemia (p = 0.001), prolonged rupture of membrane (p = 0.005), prolonged operation time (p = 0.019), and junior surgeons performing the operation (p = 0.011) were the risk factors for CS-SSI. Conclusions: Pre-and postoperative care and surgical training of junior doctors should be directed to these risk factors.

Objective: To explore the effect of aromatase inhibitors in the treatment of endometrial hyperplasia in post menopausal women.Materials and Methods: This observational longitudinal study was undertaken in 21 postmenopausal women diagnosed as having endometrial hyperplasia in a private clinic in Dhaka between July, 2009 to January 2014. Initially hyperplasia was diagnosed by thickened endometrium by ultrasound and confirmed by histopathologic examination of fractional curretage. Among the patients, 7 had complex hyperplasia without atypia; 14 had simple hyperplasia without atypia. All the patients were treated with letrozole 2.5 mg per day for 12 months and were monitored by transvaginal ultrasonogram every 3 months, subsequently followed up by history and transvaginal ultrasonogram 6 monthly for another 12 months. Main outcome measure was reduction of endometrial thickness. Informed written consent was obtained before enrollment in the study.Results: Mean endometrial thickness decreased by 81.66% following 12 months of treatment and the endometrial thickness was not increased in next 12 months follow up period. All patients were symptom free during this treatment.Conclusion: The results of this study indicate that treatment of endometrial hyperplasia with aromatase inhibitors can reduce endometrial thickness. So, aromatase inhibitors deserve attention for the conservative treatment of endometrial hyperplasia.Bangladesh J Obstet Gynaecol, 2014; Vol. 29(2) : 78-82

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