Pregnancy outcome following myomectomy.

In developing countries, abdominal myomectomy is still a modality of treatment for large and symptomatic uterine fibroid in women who wish to retain their fertility and preserve uterus. In order to assess the outcome of pregnancies after myomectomy, a prospective observational study was carried out in the Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from July 1999 and June 2011. Study included 40 married women of reproductive age, suffering either from primary or secondary subfertility, and who had uterine fibroid and strongly wished to conceive shortly after myomectomy using microsurgical procedure with no existence of other male and female subfertility factor. These women were followed up at 3, 6, 12 and 24 month intervals over telephone and outdoor visits. Data were recorded on preformed questionnaires. Post myomectomy hysterosalpingography was done at about 16 weeks after myomectomy. Patients were advised to try for pregnancy after 16 weeks of operation. Maximum number of women belonged to age group 31-35 years (n=14, 35%); primary subfertility was 67.5% and secondary 32.5%; in maximum number of cases duration of subfertility was 2-5 years (n=22, 55%); type of fibroid were solitary (52.5%) and multiple (47.5%); type of myoma were intramural (75%), submucous (2.5%) and combined (22.5%); location of myoma were fundal (5%), anterior wall (25%), posterior wall (20%) and combined (50%); diameter of removed myoma were <5cm (2.5%), 5-8cm (67.5%), >8-10(20%) and >10cm (10%); uterine size before myomectomy were (in weeks) <12(22.5%), 12-14 (27.5%), 15-20 (32.5%), 21-25 (15%) and >25 (2.5%). Hysterosalpingography was done in 16(40%) cases, and the findings were both tube patent (62.5%), unilateral tubal block (31.2%) and bilateral tubal block (6.2%). Menorrhagia after myomectomy was present only in 5% cases. After uterine myomectomy, 14(35%) women conceived, common time interval between myomectomy and conception was 1-2 years (42.9%), conception was spontaneous in 71.4%. Out of 14 who conceived after myomectomy 12(85.7%) delivered live babies by LUCS, and most of the babies weighed >3kg (58.3%).

Precocious puberty presenting with menarche at the age of 6 years - a case report.

Precocious puberty or central precocious puberty can be very confusing and truly unexpected. After all who know children could go into puberty too early? There is treatment for this condition. Present report has stated that central precocious puberty is becoming more frequent. Many factors may contribute to children who exhibit signs of early precocious puberty. Here we are reporting a case of premature menarche of 6 years old girl who initially presented with continuous per vaginal bleeding for 3 months as a onset of menarche later on after clinical examination and investigations she was diagnosed a precocious puberty due to juvenile premature hypothyroidism. After the successful treatment with thyroxin, level of TSH gradually was decreased and subsequently normal. There after per vaginal bleeding stopped and clinically improved.

Association of infertile patients having polycystic ovarian syndrome with recurrent miscarriage.

Polycystic ovarian syndrome (PCOS) has a pivotal role in the development of various complications during pregnancy. Polycystic ovarian syndrome women having elevated LH and hyper insulineuia may be at increased risk of miscarriage. The study was done to find out the recurrent pregnancy loss among the PCOS patient. This was a cross sectional case control study in total 100 infertile patients between age 20-40 years attending BSMMU out patient Department from July 2011 to June 2012, among them 50 infertile patients with PCOS regarding as a case and 50 infertile patients without PCOS selected as a control. Regarding case (infertile patients with PCOS) shows 20(40%) recurrent miscarriage and among control (infertile patients without PCOS) shows recurrent miscarriage 6(12%). And also among case group shows insulin resistance 8(16%) and control group insulin resistance 1(2%). Six (75%) abortion occur among PCOS with insulin resistance and 5(62.5%) abortion occur among PCOS with raised testosterone level. It is observed that recurrent miscarriage is higher in PCOS group. And also concluded that insulin resistance and raised testosterone level is responsible for this condition. So, further large scale study would be needed to reduce the chance of recurrent pregnancy loss by treatment with insulin sensitizer in case of obese PCOS with insulin resistance patient.

A successful pregnancy outcome following abdominal metroplasty.

A 35 years old lady presented to Out Patients Department of Bangabandhu Sheikh Mujib Medical University for secondary subfertility with history of recurrent abortion. She was diagnosed a case of bicornuate uterus following laparoscopy. After 3 months of her last abortion she was advised for metroplasty. Metroplasty was done, forming a single cavity. Dye test was positive on right side and negative on left side. After 3 months of metorplasty hysterosalphingography (HSG) was done and reports shows bilateral patent uterine tubes. One year after metroplasty. She was pregnant with letrozole and Gonadotrophin. Her pregnancy was diagnosed by ultrasonography and advised for admission. She was on regular antenatal follow up and all investigation was done. Anomaly scan was done at 20 weeks of pregnancy. She was properly immunized. Pregnancy period was uneventful until 37 weeks. At 37 weeks LUCS was done. A female healthy baby was born. APGAR score was 7/10 at 1, 10/10 at 5 minutes, baby weight 2.8kg postpartum period was uneventful. After abdominal metroplasty successful pregnancy outcome was occurred.

Lipoprotein-a: a laboratory tool for clinical categorization of CVD.

A case-control study was done to evaluate the association of Lipoprotein(a)[LP(a)] with CVD (Cerebrovascular disease) and also to assess the implication of serum LP(a) concentration as a differentiating marker between ICVD (Ischemic CVD) & HCVD (Hemorrhagic CVD). 150 non-smokers, non-alcoholic subjects free from DM, renal disease, thyroid disease and liver disease were studied. Among them 120 were CVD cases and 30 were age & sex matched healthy control. Fasting (12 hr.) blood samples were collected from all subjects and in CVD cases samples were collected after 24 hr. of attack. Serum LP(a) concentration were measured in all samples. Mean serum LP(a) concentration in control, HCVD & ICVD were found to be 17.6 +/- 7.4 mg/dl, 31.9 +/- 15.6 mg/dl and 44.8 +/- 24.0 mg/dl respectively. Both HCVD & ICVD cases showed significantly higher level of serum LP(a) concentration compared to control. Moreover ICVD cases showed significantly higher level of serum LP(a) concentration compared to HCVD cases. The exquisite athero-thrombo-embolic potential of LP(a) explain its involvement with CVD but more with ICVD in comparison to HCVD; This finding apparently suggest the prospect of serum LP(a) concentration to be used as a promising laboratory maker to differentiate clinically the ICVD from HCVD following determination of cut-off value between ICVD & HCVD by broad based comprehensive study.

Lipoprotein -- an independent risk factor for CVD.

A case control study done to evaluate the Lipoprotein(a) [LP(a)] as a risk factor for CVD (cerebrovascular disease). 150 non-smokers, non-alcoholic subjects free from DM, renal disease, thyroid disease and liver disease were included in the study. Among them 120 were CVD cases and 30 were age and sex matched healthy control. Subjects were grouped as group-I (30, healthy control), Group-II (60, Hemorrhagic CVD) and group-III (60, Ischemic CVD). Fasting (12 hr) blood samples were collected from all subjects and in CVD cases samples were collected after 24 hr of attack. Lipid profile and LP(a) conc. were measured in all samples. Mean serum LP(a) conc. in Group-I, Group-II and Group-III were found to be 17.6 7.4 mg/dl, 31.9 15.6 mg/dl and 44.8 24.0 mg/dl respectively. Both the groups of CVD cases showed significantly higher level of serum LP(a) conc. compared to healthy control. CVD cases did not differ statistically in respect of their lipid profile when compared with control. Moreover the serum LP (a) conc. of CVD cases found to show no correlation with their lipid profile, suggesting the serum LP(a) conc. a possible independent risk factor for CVD.

Biochemical and structural alterations in rat erythrocytes due to hexachlorocyclohexane exposure.

The changes in biochemical constituents of rat erythrocyte membranes were observed after a single ip exposure to 300 mg commercial HCH/kg body weight (one-third of the LD50). The phospholipid:cholesterol ratio was altered, and there were changes in the activities of the membrane-bound enzymes ATPase and acetylcholinesterase. The phospholipid content was increased while cholesterol and ATPase and acetylcholinesterase activities were significantly decreased. The erythrocytes also showed morphological changes (cell deformity and echinocyte formation).

Oxidative damage and changes in the glutathione redox system in erythrocytes from rats treated with hexachlorocyclohexane.

The concentration of reduced glutathione in the erythrocytes of rats was significantly decreased 24-72 hr after the rats were treated with 300 mg commercial hexachlorocyclohexane/kg body weight (one-third of the LD50), given ip. The activities of glutathione reductase, glutathione-S-transferase and glucose-6-phosphate dehydrogenase were also significantly decreased 24 hr after treatment but there was no change in glutathione peroxidase activity. The results suggest that hexachlorocyclohexane produces significant changes in the glutathione redox system of rat erythrocytes leading to oxidative membrane damage.

Detection of corn intrinsic and recombinant DNA fragments and Cry1Ab protein in the gastrointestinal contents of pigs fed genetically modified corn Bt11.

Genetically modified corn has been approved as an animal feed in several countries, but information about the fate of genetically modified DNA and protein in vivo is insufficient. Genetically modified corn Bt11 is developed by inserting a recombinant DNA sequence encoding insecticidal Cry1Ab protein from Bacillus thuringiensis subsp. kurstaki. We examined the presence of corn intrinsic and recombinant cry1Ab gene by PCR, and the Cry1Ab protein by immunological tests in the gastrointestinal contents of five genetically modified corn Bt11-fed and five nongenetically modified corn-fed pigs. Fragments of corn zein (242 bp), invertase (226 bp) and of ribulose-1,5-bisphosphate carboxylase/ oxygenase genes (1,028 bp) were detected in the gastrointestinal contents of both Bt11 and nongenetically modified corn-fed pigs. Fragments of recombinant cry1Ab gene (110 bp and 437 bp) were detected in the gastrointestinal contents of the Bt11-fed pigs but not in the control pigs. Neither corn intrinsic nor cry1Ab gene fragments were detected in the peripheral blood by PCR. The gastrointestinal contents were positive for Cry1Ab protein by ELISA, immunochromatography, and immunoblot; however, these methods did not work for blood and precluded conclusions about any potential absorption of the protein. These results suggest that ingested corn DNA and Cry1Ab protein were not totally degraded in the gastrointestinal tract, as shown by their presence in a form detectable by PCR or immunological tests.

Structure-activity relationships among zearalenone and its derivatives based on bovine neutrophil chemiluminescence.

We compared the effects of zearalenone (ZEN), an estrogenic mycotoxin produced by Fusarium fungi, and its derivatives--a- and b-zearalenols (Zel), zearalanone (ZAN), and a- and b-zearalanols (Zal)--on bovine neutrophils in vitro by using chemiluminescence, a bactericidal parameter. ZEN, a-Zel, and b-Zel suppressed luminol-dependent, phorbol 12-myristate 13-acetate-elicited chemiluminescence at a concentration of 10(-5) M, whereas ZAN, a-Zal and b-Zal did not. The suppressive zearalenols are derived from ZEN through reduction of the C6'-ketone into hydroxide, whereas the non-suppressive ZAN and Zal group possesses a hydrogenated C1'-2' bond in place of the double bond adopted in the macrolide ring or ZEN and the zearalenols. In consideration of these structure-activity relationships among ZEN and its derivatives, we conclude that possession of the C1'-2' double bond is essential for zearalenones to induce neutrophil suppression.

Detection of Cry1Ab protein in gastrointestinal contents but not visceral organs of genetically modified Bt11-fed calves.

The fate of insecticidal Cry1Ab protein was examined in the gastrointestinal (GI) contents and visceral organs of calves fed insect-resistant genetically modified maize Bt11. Twelve cross-breed (Japanese black x Holstein) calves were fed either Bt11 or non-genetically modified isoline maize for 90 d. Peripheral blood, rumen juice and feces were collected fortnightly, and GI contents and visceral organs were collected at slaughter at the end of the experiment. Samples were checked for Cry1Ab protein by immunological methods, and visceral organs were examined pathologically. Trace amounts of Cry1Ab protein were detected in the GI contents but not in the liver, spleen, kidney, muscle or mesenteric lymph nodes. No lesions were observed pathologically. Cry1Ab protein in the feces was degraded quickly at atmospheric temperature. These results suggested that only a trace amount of Cry1Ab protein survived passage through the GI tract but was not transferred to liver, spleen, kidney, lymph nodes or muscles.