Back ground: Cervical cancer is the most common genital tract cancer and the important cause of cancer death among Bangladeshi women. Information about actual number of women living with preinvasive phase of cervical cancer and their diagnosis and treatment is limited. For strengthening the programme and policy for cervical cancer prevention , the baseline prevalence of cervical intraepithelial neoplasia ( CIN) need to be assessed. Methods: This population based study aimed to determine the prevalence of CIN among women of Khulna division of Bangladesh. Data has been collected from four upazila of four districts of Khulna division. VIA and colposcopy and histopathology was used for detection of cervical pre-cancers and early cancers among 1232 women of the mentioned population. Results: Crude prevalence of CIN was 5.84 %,CIN-II 1.1% and CIN- III .73% in colposcopically directed biopsy. Ninety two participants with CIN received treatment at the Colposcopy Clinic of Obstetrics and Gynaecology department of Khulna Medical College Hospital (KMCH). Conclusion: This population based prevalence study of CIN and socio demography would have conducive effect on future cervical cancer prevention programme. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 21-28
Cervical cancer develops from early precancerous lesion known as cervical intraepithelial neoplasia (CIN).
Background: Carcinoma cervix is a preventable disease. It runs a long preinvasive stage, such as Normal - CIN I - CIN II - CIN III - Cancer cervix. It can be prevented at early stage of development with proper diagnosis, treatment & follow up. A major portion of CIN I spontaneously regress but some need treatment. Obiective: The purpose of this study was to determine the frequency of abnormal colposcopic findings during the 1 year follow up period in patients of CIN I treated with cold coagulation, LEEP and expectant management. Materials and Methods: This retrospective study was conducted in colposcopic centre of Khulna medical college hospital, Khulna, Bangladesh from January 2018 to December 2019. After confirmation of CIN I, ladies were arranged in three groups according to their treatment modalities - Expectant management (group A), Cold coagulation (group B) & LEEP (group C). They were reexamined with colposcopy after 6 months, or after one year of first visit. Persistence or reappearance of CIN was assayed & correlation between colposcopic results during follow up of different groups was analysed. Results: Total 195 ladies were diagnosed colposcopically as CIN I. Of them 75 women were confirmed by histological examination. Among 75 ladies, 25 ladies received no treatment, grouped as group A. Forty ladies treated with cold coagulation falls in group B, whereas 10 ladies who treated with LEEP were grouped as group C. Distribution of age, parity, monthly income, education, marital age, age at first delivery was similar in different group. During follow up persistence of disease were found in 2(13.3%) ladies who did not receive any form of treatment, 3(10.7%) who were treated with cold coagulation (p value 0.333) and 1(12.5%) lady who received treatment with LEEP (p value 0.667), were not significant. Conclusion: Colposcopic surveillance without treatment appears reasonable in treating CIN I because of the high rate of spontaneous regression of CIN 1, but adherence to the follow up should be emphasized to the patients during the follow up visits. Bang Med J Khulna 2020: 53 : 8-12
Background: First generation tyrosine kinase inhibitor, imatinib revolutionized the treatment of chronic myeloid leukaemia, and is now the front line therapy. Imatinib provides substantial cytogenetic and molecular remission, with minimal normal hematopoiesis suppression or side effects and is now first line therapy. Objective: The aim of this prospective study was to determine the efficacy of imatinib therapy in the management of chronic myeloid leukemia in Bangladesh. Methods: This prospective study was done from June 2012 to May 2018. In this period we treated eight chronic myeloid leukaemia patients with imatinib, in Khulna division, Bangladesh. Results: Majority of the patients (50%) were in the age group of 21-30 years. Three patients died as because those patients were too poor to continue drugs. Another 5 patients were in good health and continuing follow up monthly. Among five patients, one patient have two healthy son. Conclusion: Imatinib therapy is an effective treatment regimen in the management of chronic myeloid leukaemia. The best result can be obtained if CML is dignosed earlier. Bang Med J (Khulna) 2018; 51 : 40-43
Introduction: Prevention of Mother to Child Transmission (PMTCT) program, offers a range of services for women of reproductive age living with or at risk of HIV to maintain health and stop their infants from acquiring HIV. PMTCT services should be commenced before conception and throughout pregnancy, labor and breast feeding. Around 1.4 million HIV infections among children were prevented between 2010 and 2018 by PMTCT program. UNFPO started antenatal screening program in collaboration with AIDS/STD program in Bangladesh from 2013, in 12 centers (BSMMU, 4 Medical College Hospitals, 3 Sadar Hospitals, 3 Health Complexes and Memon Maternity Hospital, Chittagong). Materials and Methods: Observational study of Antenatal and postnatal cases in HIV screening in KMCH during the period of Nov’2017 to March’2020. Results: From November 2017 to March 2020, total 18,911 patients screened, 11 patients were found HIV positive. 2 patients dropped out. Among 9 patients, 6 patients were detected in antenatal and 3 in postnatal period. 6 patients had vaginal delivery, 2 elective caesarean section and 1 patient had abortion. Screening was done by Alere Determine HIV- ½ Ag/Ab Combotest and diagnosis was confirmed by Uni-Gold HIV Rapid Test and First Response HIV 1-2-0 Card test. Conclusion: Following confirmation, ARV started with proper counseling. All babies were breast fed. The neonates were screened by PCR at their age of 45 days and found negative. WHO guideline was strictly maintained during labor conduction and cesarean sections. PMTCT program should be expanded in all institutions to detect cases, reduce transmission, contraception counselling to reduce confirmed cases. Medicine Today 2021 Vol.33(1): 7-11
Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrinopathy in reproductive age women. PCOS has complex etiopathology, diverse clinical presentation and diagnostic criteria. Objective: Objective of this study was to find out the determinant clinical feature and investigations for improving diagnostic accuracy and assessment of PCOS, thereby evolving opportunity for proper treatment. Methods: This prospective cross sectional observational study was conducted in Islami Bank hospital, Khulna, from January 2017 to February 2020. Women seeking gynecological consultation in outdoor with at least one complaint of oligomenorrhoea, hirsutism, weight gain or infertility were enrolled for study. Subjects were selected on the basis of inclusion and exclusion criteria. A structured proforma, based on relevant history, laboratory work up, risk factors and co morbidities were prepared before-hand. Diagnosis of PCOS was based on Rotterdam criteria, 2003. The clinical manifestations of PCOS, frequency of different sub phenotypes and associated morbidities were measured as outcome. Results: Total study population was 202. Age of subjects were in between 13- 37 years. Thirty seven (18%) were adolescent, one hundred forty (65.7%) patients were overweight and obese. Majority of cases were married. Complaint of infertility was present in 125 (61.9%) cases. Oligomenorrhoea, hirsutism, poly cystic ovary was present in 145 (71.8%), 137 (67%), and 130 (64.4%) patients respectively. LH/FSH ratio >2 in 45 (22.3%) cases, Serum free testosterone >0.79 ngm/ml were associated with hirsutism. PCOS with clinical sub phenotypes A, B, C, and D were 38(18.9%), 72 (35.6%), 27 (13.4%) and 65 (32.2%) cases respectively. Case morbidities were Hypertension 75 (37.1%), Diabetes mellitus 18 (8.9%) and Metabolic syndrome 44 (20.1%). Link with Hypothyroidism Hyperprolactinemia were identified in 47 (19%) cases. Conclusion: Oligo-anovulatory woman with hyperandrogenism with or without poly cystic ovary were diagnosed as a largest group of PCOS-A and B sub phenotypes. Infertility, hypothyroidism, hypertension, diabetes mellitus, metabolic syndrome and endometerial hyperplasia were common. Bang Med J Khulna 2020: 53 : 17-22
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