Background: This study was done to evaluate the association of serum vitamin D level with GDM (n=30) and without GDM (n=30). The age and body mass index of the participants along with their gestational age, gravidity and parity were harmonized. The serum vitamin D levels and blood glucose were investigated. The results revealed that, normal pregnant women had significantly higher vitamin D level than their GDM counterparts.Methods: This case-control study was conducted on healthy pregnant women attending routine antenatal care at Bangabandhu Sheikh Mujib medical university from January 2019 to December 2019 recruited at third trimester of gestation. We measured maternal serum vitamin D status (25[OH]D) in third trimester of pregnancy. GDM was diagnosed according to the American diabetes association. guidelines. Vitamin D status was defined as, vitamin D sufficiency (≥30 or ≥75 nmol/L), insufficiency (20-30 and 50-75 nmol/L), were used to categories participants according to their 25[OH]D concentrations. We calculated adjusted odds ratios and 95% confidence intervals (CIs) using logistic regression.Results: The mean serum vitamin D level was lower in case group case 23.4 (17.4±35.1) compared to that in control group 29.7 (15.4±39.8) and the difference between the 2 groups was statistically significant (p≤0.001). Sufficient level of vitamin D was more in control group (66.7%) than that of case group (26.1%). Insufficient level of vitamin D was higher in case (73.3%) group than that of control (33.3%) group. These findings were significant (p=0.021). Respondents with insufficient level of vitamin D have 3.1 times more chance to develop GDM.Conclusions: Serum vitamin D level is reduced in pregnant women having GDM.
Background: Cervical intraepithelial neoplasia (CIN) is usually a precancerous condition but, if left untreated, can develop into invasive cervical cancer. CIN2 and CIN3 are combinedly termed high-grade squamous intraepithelial lesions (HSIL). There are few screening tests based on cytology in detecting HSIL, but they are mostly less accurate. There is over-expression of p16 in pre-cancer and cancer of the cervix. The purpose of this study was to determine the value of p16 expression in the detection of HSIL. Methods: It was a cross-sectional study conducted in the colposcopy clinic of the Department of Obstetrics and Gynecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from October 2021 to March 2022. The study included 72 HSIL patients detected by colposcopy and had subsequent cervical biopsy and p16 immunohistochemistry. Results: Majority (45.8%) of the patients were found within the 30-39 years age group, 44.4% of the participants were illiterate, and 76.4% came from the middle-income group. Colposcopy-directed cervical Punch or Loop electrosurgical excision procedure (LEEP) biopsy revealed that 70.5% of patients had HSIL, and the rest (64.3%) suffered from LSIL. Positive p16 results were significantly higher among the HSIL group (84.1%) compared to those other than the HSIL group (3.6%) (p<0.001). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the p16 in the detection of HSIL were 84.1%, 96.4%, 79.4%, and 88.9%, respectively. Conclusions: Immunohistochemistry for p16 has a high diagnostic value in detecting HSIL patients. Therefore, this could be recommended for appropriate management of patients with CIN to avoid misdiagnosis and the over or under-treatment.
Background: Cervical cancer develops from well-defined precursor lesions in a variable period of time. Detecting in early or pre invasive stages, cervical cancer is preventable and curable, so detection of preinvasive lesions is very important. Objectives: The aim of our study was to correlate of Pap smear and colposcopy in relation to histopathological findings in detection of preinvasive lesion of cervix. Methods: This was a cross-sectional study of 110 women to attend in department of Gynecological Oncology OPD of Bangabandhu Sheikh Mujib Medical University Hospital from July 2016 to June 2017. Inclusion criteria were age of 30 to 60 years, who had unhealthy cervix, intermenstrual or post coital bleeding and excessive vaginal discharge. Exclusion criteria were any cervical growth, bleeding at the time of examination, pregnant women. Result: In present study sensitivity of Pap smear for detecting lesions above LSIL was 11(10.0%), specificity 68.38%, PPV was 94.44%, negative predictive value 71.86%. The incidence of preinvasive lesions (LSIL and HSIL) was 33.64% with LSIL 21(19.09%) and HSIL 16(14.55%) and of carcinoma were 10(9.09%). Conclusion: With a comprehensive approach to make awareness and doing proper screening by Paps smear, colposcopy and colposcopy directed biopsy; cervical cancer can be eliminated as a public health problem within a generation. Bangladesh Medical Res Counc Bull 2022; 48(3): 189-194
Background: Myomectomy can be performed during cesarean section. Objective: The purpose of the present study was to assess the safety and efficacy of myomectomy during cesarean section. Methodology: The study design was a prospective multi-centre study done in three tertiary care hospitals Dhaka Medical Collage, BSMMU & private Hospital in Dhaka City. The subject were 65 pregnant women elective or emergency myomectomy during cesarean section. All cesarean section myomectomy were performed by consultants. Intra-operative and post-operative complications such as change in haematocrit, length of operation, blood loss were estimated. Length of hospital stay was also recorded. Results: 79 Fibroid of various sizes (2 to 6cm) were removed from 65 women. Fibroid were on the anterior uterine wall with most being sub serous and intra mural. Four patients had one unit of whole blood transfusion in post-operative period. No hysterectomy was done at the time of cesarean section. There was no significant change of haematocrit: incidence of post-operative fever and duration of operation. The mean duration of post-operative hospital study was 7.3±1.2 days, 5 patients subsequently became pregnant, were also underwent repeated cesarean section in the study period. Conclusion: In selected cases myomectomy during cesarean section does not appear to result in an increased risk of intrapartum or short-term post-partum morbidity if performed by an experienced practitioner. Cesarean myomectomy is a safe surgical options with no significant complications. Journal of Current and Advance Medical Research 2019;6(1):18-22
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