Anti-rheumatoid arthritis potential of Halodule pinifolia: development, characterization and in vivo evaluation of H. pinifolia-based oral suspension and lipid nano-emulsion.

For treating chronic diseases like rheumatoid arthritis, herbal medicines are preferred due to their evident therapeutic effects and lesser side effects as compared to the long-term used conventional drugs. In this study, the anti-rheumatoid arthritis effect of an unexplored marine grass Halodule pinifolia (HP), and a combination of it with Glycyrrhiza glabra (liquorice; LQ), prepared as a conventional suspension (C1) and a lipid nano-emulsion (C1-N) was evaluated in Freund's complete adjuvant (FCA)- and collagen-induced arthritis (CIA) models. Formulations C1 and C1-N contained standardized extract HP (100 mg/kg) as major active ingredient and liquorice LQ (50 mg/kg) as both active ingredient (anti-inflammatory and anti-ulcer) and sweetening agent. Oral administration of HP and C1 to FCA-induced Sprague-Dawley rats significantly reduced the paw oedema, spleen index, controlled the haematological parameters, cytokine levels (IL-1ß, IL-6, TNF-α estimated by ELISA), mRNA expression of cytokines and osteoclast markers (RANK, TRAP and cathepsin K measured by RTPCR). Histopathology and radiological scanning demonstrated lesser joint deterioration in sample-treated rats, as evident phenotypically. The downregulation of CD51 and MMP-3 (western blot) corroborated the anti-arthritic effect of HP and C1. HP showed better results among all. Further, under the CIA model, both C1 and C1-N were found to be potentially active as evidenced by their effect on rat paw oedema, spleen index, haematological parameters, rheumatoid factor, cytokines, osteoclast markers, histology and X-rays. The results proved the anti-arthritic effect of HP and the formulations, particularly the lipid nano-emulsion that showed improved stability as well as activity.

Brain tumor classification for MRI images using dual-discriminator conditional generative adversarial network.

This research focuses on improving the detection and classification of brain tumors using a method called Brain Tumor Classification using Dual-Discriminator Conditional Generative Adversarial Network (DDCGAN) for MRI images. The proposed system is implemented in the MATLAB programming language. In this study, images of the brain are taken from a dataset and processed to remove noise and enhance image quality. The brain pictures are taken from Brats MRI image dataset. The images are preprocessed using Structural interval gradient filtering to remove noises and improve the quality of the image. The preprocessing outcomes are given to feature extraction. The features are extracted by Empirical wavelet transform (EWT) and the extracted features are given to the Dual-discriminator conditional generative adversarial network (DDCGAN) for recognizing the brain tumor, which classifies the brain images into glioma, meningioma, pituitary gland, and normal. Then, the weight parameter of DDCGAN is optimized by utilizing Border Collie Optimization (BCO), which is a met a heuristic approach to handle the real world optimization issues. It maximizes the detection accurateness and reduced computational time. Implemented in MATLAB, the experimental results demonstrate that the proposed system achieves a high sensitivity of 99.58%. The BCO-DDCGAN-MRI-BTC method outperforms existing techniques in terms of precision and sensitivity when compared to methods like Kernel Basis SVM (KSVM-HHO-BTC), Joint Training of Two-Channel Deep Neural Network (JT-TCDNN-BTC), and YOLOv2 including Convolutional Neural Network (YOLOv2-CNN-BTC). The research findings indicate that the proposed method enhances the accuracy of brain tumor classification while reducing computational time and errors.

This research focuses on improving the detection and classification of brain tumors using a method called Brain Tumor Classification using Dual-Discriminator Conditional Generative Adversarial Network (DDCGAN) for MRI images. Brain tumors can significantly impact normal brain function and lead to loss of lives, making timely diagnosis crucial. However, the process of locating affected brain cells is often time-consuming. In this study, images of the brain are taken from a dataset and processed to remove noise and enhance image quality. The proposed method employs the Empirical Wavelet Transform (EWT) for feature extraction and utilizes the DDCGAN to classify brain images into different types of tumors (glioma, meningioma, pituitary gland) and normal brain images. The weight parameter of DDCGAN is optimized using Border Collie Optimization (BCO), a method to handle real-world optimization issues. This optimization aims to maximize detection accuracy and minimize computational time. Implemented in MATLAB, the experimental results demonstrate that the proposed system achieves a high sensitivity of 99.58%. The BCO-DDCGAN-MRI-BTC method outperforms existing techniques in terms of precision and sensitivity when compared to methods like Kernel Basis SVM (KSVM-HHO-BTC), Joint Training of Two-Channel Deep Neural Network (JT-TCDNN-BTC), and YOLOv2 including Convolutional Neural Network (YOLOv2-CNN-BTC). The research findings indicate that the proposed method enhances the accuracy of brain tumor classification while reducing computational time and errors.

Prospective Leads from Endophytic Fungi for Anti-Inflammatory Drug Discovery.

A wide array of therapeutic effects has been exhibited by compounds isolated from natural sources. "Bio-actives of endophytic origin" is a recently explored area that came into recognition over the last 2 decades. Literature search on the secondary metabolites of endophytes have shown several pharmacologically active compounds especially anti-inflammatory compounds, which have been reviewed in the present paper. The article is structured based on the chemical classification of secondary metabolites. The compounds were identified to possess activity against a total of 16 anti-inflammatory targets. The most common targets involved were NO, TNF-α, and inhibition of total ROS. Further, the article gives a detailed insight into the compounds, their endophytic source, and anti-inflammatory target as well as potency. The contents of the article cover all the scientific reports published until Feb. 2019. Thus 118 compounds and 6 extracts have been reported to be obtained from endophytic sources showing anti-inflammatory activities. Amongst these, herbarin, periconianone A, and periconianone B were identified as the most potent compounds in terms of their IC50 values against NO inhibition.

Comparative genomics of Vibrio cholerae O1 isolated from cholera patients in Bangladesh.

Whole genome sequencing was utilized to investigate the genomic profile of Vibrio cholerae O1 strains, isolated from symptomatic patients in a low-income urban area of Dhaka, Bangladesh. Comparative genomics using bioinformatics tools were applied to identify major virulence factors, biotype and antimicrobial resistance genes in three V. cholerae O1 strains (VC-1, 2 and 3) isolated from two case patients. A phylogenetic SNP (single nucleotide polymorphism)-based analysis was conducted to infer the relatedness to V. cholerae O1 strains isolated elsewhere. The V. cholerae strains were the El Tor variant carrying ctxB1 (standard classical genotype). SNP-based global phylogeny revealed that the three isolates were strictly clonal and the closest neighbouring genomes were epidemic clones of V. cholerae O1 isolated in 2010 from cholera patients in Pakistan. All strains harboured the integrase gene of the SXT element (intSXT ), antimicrobial resistance genes for aminoglycosides, phenicol, sulphonamide and trimethoprim except VC-1 that lacked sulphonamide resistance genes. The multilocus sequence typing (MLST) revealed that the strains belonged to sequence type, ST69. The study provides knowledge on current genetic traits of clinical V. cholerae O1 circulating in urban household clusters of Bangladesh which may help in predicting emergence of new pandemic strains in Bangladesh. SIGNIFICANCE AND IMPACT OF THE STUDY: Vibrio cholerae has frequently experienced genetic changes with rapid evolution of pandemic clones in the Ganges Delta region. Whole genome sequencing can reveal genetic information of current pathogenic V. cholerae in Bangladesh which includes cefotaxime genotypes, virulence factors, altered antimicrobial resistance pattern as well as mobile genetic element compared to global pandemic strains. This study data could be used in planning future surveillance strategies in Ganges Delta region by informing new epidemiology of current outbreak strains.

Ovarian reserve after internal iliac artery ligation.

AIM: Ligation of major vessels supplying ovaries may alter hormones and ovarian reserve due to disturbances of vascular circulation. Our purpose is to measure serum anti-Müllerian hormone (AMH) levels and ovarian volume in patients who had internal iliac artery ligation (IIAL) and/or IIAL plus hysterectomy due to uterine atony. METHODS: Patients who underwent IIAL and IIAL+ hysterectomy were evaluated 6 months after their operations and were compared with the control group. The hormones, ovarian volume and antral follicle count (AFC) were measured in each group. RESULTS: Serum AMH levels in the post-partum 6th month interval were lower in the IIAL group than in the control group and were the lowest in the IIAL+ hysterectomy group. Similar to AMH results, AFC and ovarian volumes were also lowest in the IIAL+ hysterectomy group. CONCLUSION: IIAL and hysterectomy are lifesaving interventions during peripartum hemorrhage; however, they might alter ovarian reserve in the short term.

Orlistat (The Lipase Inhibitor) Therapy in Overweight and Obese Subfertile Women.

This experimental study was carried out to evaluate the efficacy of orlistat (a pancreatic lipase inhibitor) therapy over lifestyle change on weight reduction and ovulation in overweight and obese subfertile women. It was carried out in Department of Gynecology and Obstetrics, Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka, Bangladesh from August 2015 to January 2016. Subfertile obese and overweight female patients attending the study centre during study period was considered as study population. Subfertile women with normozoospermic husband with BMI (25-40) Kg/M2, age (18-35) years with no history of taking medication or dietary modification for weight loss currently or for the preceding 3 months were included in this study but subfertile patients having laparoscopic ovarian drilling and metformin and those with structural abnormalities in reproductive tract and known hormonal and medical disorder were excluded from this study. Detailed history taking, physical examination including weight, Body Mass Index (BMI) and baseline relevant investigations were done. Transvaginal sonography (TVS) on day 12 and day 14 of menstrual cycle was done for evaluation of ovulatory status of the patients. Counseling was done about life style change by diet of low glycemic index and moderate exercise. Following written informed consent, 120 patients were enrolled into either of the two groups. Group I received capsule Orlistat 120 mg twice daily for 3 months period. Group II was counseled for life style modification only. Post treatment weight measurement and TVS on day 12 and 14 were done after completion of intervention. Then pre and post-treatment parameters were assessed between two groups. Mean age was (27.31±4.58) years in Group I and (26.20±4.71) years in Group II. Majority patients, (78.3%) in Group I and (76.7%) in Group II had oligomenorrhoea. Hirsuitism was observed in (25%) in Group I and (43.3%) in Group II. Mean weight (kg) at booking was (72.26±7.81) in Group I and (67.10±5.93) in Group II; after 3 months (67.77±7.82) and (63.55±6.07). Reduction of weight (%): (6.52±2.28) in Group I and (5.33±2.14) in Group II which was significantly higher in Group I than that of Group II in (25.0-29.9) BMI. Ovulation assessed by TVS at booking and after 3 months in Group I: 13(21.7%) and 37 (61.7%) and in Group II: 14 (23.3%) and 27 (45.0%). Ovulation was higher in Group I than that of Group II, but the difference was not statistically significant. Majority of the overweight and obese subfertile patients suffered from oligomenorrhoea and anovulation. Weight significantly reduced in both groups along with ovulation improvement, more in Group I, but insignificant in between groups. Therefore this study suggested that orlistat can improve ovulation as it acts indirectly by weight reduction more than life style modification alone.

Role of Serum Pepsinogen I and II Ratio in Screening of Gastric Carcinoma.

In spite of the global decline in its incidence and mortality, gastric carcinoma still remains a major cause of death due to cancer. Early detection of gastric carcinoma is expected to reduce mortality rates. The applications of measuring of pepsinogen I and pepsinogen II are useful in screening of gastric carcinoma. This cross sectional comparative study was done to find out the correlation of histopathological pattern of gastric carcinoma with serum pepsinogen I & II ratio in the Department of Pathology, Sylhet MAG Osmani Medical College, Sylhet, Bangladesh from January 2010 to December 2010. For these purpose 40 patients with gastric carcinoma, endoscopically visible and histopathologically proved malignant lesions were enrolled as case group. Forty subjects with normal upper GI endoscopy were taken as control. Five ml of venous blood was taken from both case and control subjects to determine serum pepsinogen I and pepsinogen II level by ELISA method, subsequently pepsinogen I and II ratio was calculated. In this study different cut off values of serum pepsinogen I and II ratio was determined and the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 70.0%, 97.5% 96.6% 76.5% and 83.8% respectively, at cut off value of 6. Which is the most suitable cut off point of serum pepsinogen I and II ratio for gastric cancer screening.

A Retrospective Histopathological Study on Extra-pulmonary Tuberculosis in Mymensingh.

Tuberculosis is a very common disease in our country. This retrospective histopathological study was designed to assess the distribution of extra-pulmonary tuberculosis (EPTB) in various organs through examination of biopsy specimens. A total of 216 specimens were diagnosed as tubercular lesion by histopathological evaluation in the Department of pathology, Community Based Medical College and a private laboratory during the period from January 2014 to December 2014. Mean age of the case was 32 years. Majority of the cases were female (126 out of 216). Lymph nodes were the most common site of EPTB (62.96%) followed by skin and subcutaneous tissue (17.59%), intestine (11.11%), breast (2.77%), female genital tract (2.31%), male genital tract (1.38%), bone and joint (1.85%). Out of 136 cases of tubercular lymphadenitis, 96(70.58%) were cervical, 18(13.23%) were axillary, 12(3.82%) were mesenteric and 10(7.35%) were inguinal. This study reveals, in our locality, EPTB is very common in adulthood with female preponderance. Cervical lymph node is very common sites for EPTB.

Challenges in HbA1C Level as a Diagnostic Tool of Diabetes and Pre-Diabetes in Middle-Aged Population: The Bangladesh Study.

Worldwide prevalence of diabetes is found to be the human health at an alarming rate. However, large numbers of patient remain undiagnosed. Oral glucose tolerance test (OGTT) still is regarded as gold standard in diagnosis of blood glucose abnormality. Although the less number of bodies are considering measurement of HbA1C as an alternate tool to identify risk group. This study was undertaken to evaluate the role of measurement of HbA1C in the diagnosis of diabetes and pre-diabetes in middle-aged Bangladeshi subjects and carried out in the department of Biochemistry, BIRDEM from July 2013 to June 2014. A total 177 subjects of age within the range of 30-45 years were selected for the purpose and classified into healthy control (n=62) pre-diabetes (n=69) and diabetes (n=46) groups based on the values of OGTT. Middle aged Bangladeshi subjects attending Bangladesh Institute of Research & Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) hospital, the HbA1C values were 5.0-5.6% in control group, 5.6-6.2% in pre-diabetes and 8.1-9.7% in diabetes group (95% CI). The optimal cut-off value of HbA1C related to pre-diabetes diagnosed by OGTT was 5.6%, which showed the sensitivity 47.8%, specificity 74.2%, positive predictive value 67.3% and negative predictive value 58.5%. Variants of hemoglobin especially Hemoglobin E (HbE) is prevalent in South East Asia including Bangladesh. The presence of genetic variants of hemoglobin can profoundly affect the accuracy of HbA1C measurements. So measurement of HbA1C may not be used as an alternate tool of OGTT to identify people of diabetes and pre-diabetes in certain situation.

Optimization of Electrochemical Treatment Process Conditions for Distillery Effluent Using Response Surface Methodology.

Distillery industry is recognized as one of the most polluting industries in India with a large amount of annual effluent production. In this present study, the optimization of electrochemical treatment process variables was reported to treat the color and COD of distillery spent wash using Ti/Pt as an anode in a batch mode. Process variables such as pH, current density, electrolysis time, and electrolyte dose were selected as operation variables and chemical oxygen demand (COD) and color removal efficiency were considered as response variable for optimization using response surface methodology. Indirect electrochemical-oxidation process variables were optimized using Box-Behnken response surface design (BBD). The results showed that electrochemical treatment process effectively removed the COD (89.5%) and color (95.1%) of the distillery industry spent wash under the optimum conditions: pH of 4.12, current density of 25.02 mA/cm(2), electrolysis time of 103.27 min, and electrolyte (NaCl) concentration of 1.67 g/L, respectively.

Spectrum of Salivary Gland Lesions in a Tertiary Level Hospital.

Salivary gland tumors are relatively infrequent and account for less than 2% of all human tumors. This study was conducted to see the prevalence of patterns of non neoplastic and neoplastic lesions of salivary glands in greater Mymensingh. It was a retrospective study carried out in the department of Pathology, Community Based Medical College Bangladesh from January 2010 to December 2012. Heamatoxylin and eosin stained sections were studied in all cases. Total 98 cases of salivary gland lesions were retrieved and evaluated. Out of them 55 cases were female and 43 were male. Mean age of the cases were 42 years. Among the salivary gland lesions non-neoplastic lesions 24.48% and neoplastic lesions 75.51%. Among neoplastic lesions benign tumor comprises 91.89% and malignant tumor comprises 8.10%.

Subjective cognitive complaints across the adult life span: a 14-year analysis of trends and associations using the 1993, 2000 and 2007 English Psychiatric Morbidity Surveys.

BACKGROUND: Cognitive complaints are common in all age groups but most often researched in old age. We aimed to investigate prevalences and time trends over 14 years of subjective memory complaints (SMC) and subjective concentration complaints (SCC) in adults and investigate associations with mood disorders and cognitive function. METHOD: Data from three English national mental health surveys carried out in 1993, 2000 and 2007 were analysed. SMC and SCC were measured using the Clinical Interview Schedule-Revised and cognitive function using the modified Telephone Interview for Cognitive Status. RESULTS: Both SMC and SCC increased up to middle age and then declined, followed by a second rise in the very oldest age groups. Age-specific prevalence of both increased across survey years but relationships with mental health and cognitive outcomes were relatively stable. CONCLUSIONS: Cognitive complaints are most common in middle age and have become more prevalent over time.

Synthesis, characterization, biological and catalytic applications of transition metal complexes derived from Schiff base.

A novel series of Cu(II), Ni(II), Zn(II), Co(II), and Cd(II) complexes have been synthesized from the Schiff base. Structural features were determined by analytical and spectral techniques like IR, (1)H NMR, UV-vis, elemental analysis, molar electric conductibility, magnetic susceptibility and thermal studies. The complexes are found to be soluble in dimethylformamide and dimethylsulfoxide. Molar conductance values in dimethylformamide indicate the non-electrolytic nature of the complexes. Binding of synthesized complexes with calf thymus DNA (CT DNA) was studied. There is significant binding of DNA in lanes 2, 3, and 5. Lanes 4 and 6 are showing more florescence when compared to the control indicating that these molecules are strongly bound to the DNA by inserting themselves between the two stacked base pairs and exhibiting their original property of fluorescence. Angiogenesis study has revealed that the compounds B-2, B-4 and B-5 have potent antitumor efficacy and activation of antiangiogenesis could be one of the possible underlying mechanisms of tumor inhibition.

Synthesis, antioxidant, and xanthine oxidase inhibitory activities of 5-[4-[2-(5-ethyl-2-pyridinyl)ethoxy]phenyl]methyl]-2,4-thiazolidinedione derivatives.

Xanthine oxidase (XO) is a complex metalloflavoprotein, the overproduction of which usually leads to a pathological condition called gout. The XO inhibitors may prove to be promising antigout agents. The XO generates superoxide anions and H2O2 for the self-defense system of the organism. Abnormal production of this superoxide (reactive oxygen species) is responsible for a number of complications including inflammation, metabolic disorder, cellular aging, reperfusion damage, atherosclerosis, and carcinogenesis. In this paper, we report the synthesis of N-substituted analogs of thiazolidinedione derivatives as effective and new class of XO inhibitors and also as antioxidant agents. Among all the compounds in the series, compound 2i produced relatively better activity against human milk XO (72% inhibition), which was also supported by docking studies.

Synthesis, xanthine oxidase inhibition, and antioxidant screening of benzophenone tagged thiazolidinone analogs.

A series of novel 2-(diaryl methanone)-N-(4-oxo-2-phenyl-thiazolidin-3-yl)-acetamides were synthesized by various Schiff bases of (4-benzoyl-phenoxy)-aceto hydrazide with thioglycolic acid. The structures of the newly synthesized compounds were confirmed by IR, (1) H NMR, mass spectra, and C, H, N analysis. Further, all the synthesized compounds 9a-n were evaluated for xanthine oxidase (XO) inhibition and antioxidant properties. Among all the tested compounds, 9f, 9m, and 9n demonstrated potent XO inhibition of 52, 76, and 26%, respectively, compared to the standard drug allopurinol, which is evident from in vitro and in silico analysis. On the other hand, compounds 9c, 9d, and 9k exhibit potent antioxidant properties.

Vaginal rhinosporidiosis: a case report.

The female genital tract is an extremely rare site for Rhinosporidiosis. Here we described a 13 year old girl who presented with a slow growing polypoid fleshy mass in the posterior vaginal wall near the orifice for 6 months with scanty bleeding from the mass. The girl was admitted to hospital with profuse watery vaginal discharge. Excision of the mass was followed by histopathological examination which confirmed the diagnosis Rhinosporidiosis.

Long versus standard initial prednisolone therapy in children with idiopathic nephrotic syndrome.

The efficacy of longer initial course of prednisolone with standard regimen was compared in children with idiopathic nephrotic syndrome (INS). It was a randomized controlled trial in which patients with INS who responded to initial course of prednisolone, either long or standard regimen were included and followed for one year after completion of treatment of first attack. The long regimen consisted of prednisolone 60mg/m²/day for six weeks followed by 40mg/m² every alternate day single morning dose for further six weeks. The standard regimen consisted of prednisolone 60mg/m²/day for four weeks followed by 40mg/m² every alternate day single morning dose for further four weeks. There were 93 children who fulfilled the criteria of the study, 47 from long group and 46 from standard group though ultimately 72 completed the study (41 from long and 31 from standard group). The primary outcome measure was relapse within next one year. Relapse within one year was noted in 73.2% of long and 64.5% of standard group. The odds ratio for relapse within one year was 0.80 (95% confidence interval 0.22, 2.05). This did not reach statistical significance (p=0.696). Adverse effects of prednisolone between two groups were also not statistically significant (p>0.05). Prolongation of prednisolone therapy for initial episode of steroid-sensitive INS does not have a beneficial effect on the outcome in next one year.

Unravelling the oxygen factor - An investigation of transcriptional activation of hypoxia associated placental angiogenesis in recurrent pregnancy loss (RPL) patients from Assam, India.

INTRODUCTION: Recurrent pregnancy loss (RPL) is defined as the spontaneous loss of two or more consecutive pregnancies before 20 weeks of gestation, and affects 7.46 % of the Indian population. About 40-50 % of RPL cases are idiopathic making it a therapeutic challenge for clinicians. This study focuses on elucidating the role of hypoxia-associated placental angiogenesis in these idiopathic RPL cases. METHODS: Whole blood and product of conception (POCs) were collected from RPL patients (N = 87) and cases of voluntary abortions (medically terminated pregnancy, MTP; n = 110) as controls with informed consent. Serum separated from whole blood was used to study the ROS-antioxidant status in the cases and controls through colorimetric assays and ELISA. The mRNA extracted from placental tissue samples were used to determine the hypoxic and angiogenic status in cases and controls through real time PCR. Statistical analysis was also carried out to correlate the differential hypoxic status between RPL and MTP cohorts with the expression of angiogenic factors (VEGFA, VEGFR1 and VEGFR2). RESULTS: HIF1α mRNA expression was found to be upregulated in the RPL cases. While the serum levels of H2O2 (p = 0.012), guanine oxides and lipid hydroperoxides (LPO) were increased in the RPL cases, reduced glutathione (GSH) was found to be significantly decreased (p = 0.012). Additionally, AUROC analysis also shows an excellent discriminatory ability of 0.850 for serum H2O2 levels. VEGF-A and VEGF-R1 mRNA expression was also found to be downregulated in the RPL cases compared to MTP. DISCUSSION: This study indicates that increased oxidative stress may lead to aberrations in the VEGF pathway resulting in improper placentation in RPL cases, and subsequently, pregnancy loss.

Indication and Post-operative Complication of Primary Caesarean Section in Multiparous Women in A Tertiary Level Hospital.

The spectrum of indications for primary caesarean section changes with advancing parity. As parity advances more cesarean section are done for maternal rather than fetal indications. The objective of this study was to determine the indications and complications of caesarean section in multiparous women with history of previous vaginal delivery. This cross-sectional descriptive observational study was conducted in Mymensingh Medical College Hospital from January 2019 to June 2019 among 100 purposively selected multiparous women who underwent primary caesarean section. A well-designed, semi-structured questionnaire was used to collect data by face-to-face interview, clinical examinations and laboratory investigations. Data analysis was conducted in SPSS 20.0 version. Majority (74.0%) of the women in this study were in the age group 21-30 years with mean age of 26.3±5.76 years. Majority of the patients were of second gravida (42.0%) followed by third gravida (33.0%). The highest gravida in this study was 6th. Most of the patients were of para 1(44.0%). Highest para in this study was para 5. The most common indication of caesarean section in this study was foetal distress (26.0%). The next common indications were cephalo-pelvic disproportion (22.0%), antepartum haemorrhage (13.0%), mal-presentaion or mal-position (16.0%). Other causes were PROM (8.0%), prolonged labour (6.0%), cord prolapse (2.0%), post-dated pregnancy (4.0%), severe pre-eclampsia (2.0%) and secondary subfertility (1.0%). There was no case of maternal mortality in this study but 15 mothers suffered from various post-operative complications like wound infection (4.0%), UTI (4.0%), puerperal pyrexia (3.0%), postpartum haemorrhage (3.0%) and paralytic ileus (1.0%). Among the babies delivered 97 were live births. Among the 97 live births 11(11.34%) were preterm babies. Among the babies delivered majority (85.0%) was with good APGAR score (7-10). In conclusion it can say that a multiparous women in labour requires the same attention as that of primigravida. A parous women needs good obstetric care to improve maternal and neonatal outcome and still keeping caesarean section to a lower rate.

Analysis of Socio Demographic Risk Factors of Cervical Intraepithelial Neoplasia at Colposcopic Clinic in Mymensingh Medical College Hospital.

Cervical intraepithelial neoplasia (CIN) is a pre-malignant lesion of the cervix of uterus. Several risk factors increased the risk of developing CIN. Purpose of this study was to evaluate the socio-demographic risk factors related to CIN at our setting. This Cross sectional observational study was performed at Colposcopic clinic of Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from 9th November 2017 to 8th May 2018. Overall demographic features of 50 patients of precancerous cervical lesion show that, most of the patients belonged to the age group 30-39 years (46.0%), mean age was 32.7±10.3 years. Maximum numbers of respondents came from rural area (58.0%), followed by urban area (42.0%). Among them house wife- 46.0%, daily worker- 30.0% and illiterate 36.0%, primary level of education 32.6%. Among the patients the poor class 46.0% and 58.0% of the respondents were married at age ≤19 year. Among the respondents, (26.0%) were conceived their first child 1 month after their marriage and 54.0% of the women within 12 months of marriage. In this study multipara were (62.0%). Oral contraceptive pill was taken by (42.0%) of patients. The association of risk factors revealed that betel or tobacco chewing present in 28.0% cases; history of menstrual regulation (MR), dilatation, evacuation and curettage (DE&C), miscarriage were in 26.0% cases, family history of cancer were in 16.0% cases and multiple sexual exposure was in 10.0% cases. Women develop pre-malignant cervical lesions require early treatment. It is recommended that provision of proper health care support, early detection of CIN and proper management, can reduce the fatal outcome of the disease.