Effect of Meconium Staining Amniotic Fluid on Fetal Outcome.

Meconium-stained amniotic fluid is the passage of meconium by a fetus in utero during the antenatal period or in labour. It has for long been considered to be a bad predictor of fetal distress and meconium aspiration syndrome (MAS). The objective of this study was to find out the fetal outcome of MSAF and clear amniotic fluid. This cross- sectional comparative study was carried out in Upazilla Health Complex, Palash, Narshingdi from July 2016 to June 2017. A total of 100 pregnant women among them 50 women with MSAF and 50 women with clear liquor were studied to see the record of ANC, mode of delivery and fetal outcome by APGAR score. Study showed that among MSAF group 76.0% (n=38) had irregular ANC and 24.0% (n=12) had regular ANC whereas in clear liquor 86.0% (n=43) had regular ANC 14.0% had irregular ANC. Among MSAF (50 cases) thick meconium was in 20 cases (40.0%) and thin meconium was in 30 cases (60.0%). Regarding mode of delivery 52.0% (n=26) MSAF cases had instrumental delivery and Caesarean section compared to 24.0% (n=12) in clear liquor group. Regarding thick MSAF among 40.0% (n=20), (n=14) had low APGAR score and (n=6) had normal score at one minute and (n=9) low APGAR score and (n=11) normal score at five minutes. In clear liquor, among 100.0% (n=50), 20.0% (n=10) had low APGAR score and 80.0% (n=40) had normal score at one-minute and at five minutes 8.0% (n=4) had low APGAR score and 92.0% (n=46) had normal score. Among MSAF 26.0% (n=13) were admitted to SCBU compare to 12.0% (n=6) in clear liquor group. The mean SCBU stay was 3.1 days in MSAF whereas 1.2 days in clear liquor. Among MSAF babies 4.0% (n=2) had MAS compared to no MAS in clear liquor group. Regarding Survivalist 92.0% (n=46) were alive in MSAF whereas 100.0% all (n=50) were alive in clear liquor group.

Comparison of Serum Phosphorus Level among Women with Preeclampsia and Normal Pregnancy.

Pregnancy is a physiological state. During pregnancy increased physiological changes may lead to many biochemical and anatomical alterations. The biochemical changes that seen in blood of the pregnant mother are exaggerated in various complications of pregnancy like preeclampsia. Preeclampsia is a dangerous complication that may leads to maternal and neonatal mortality. Globally it affects 3.0-5.0% of pregnant women. The study was done to analyze the changes in serum phosphorus level in pre-eclamsia compared with normal pregnancy. The study was cross sectional and was performed from July 2016 to June 2017 in the department of Biochemistry, Mymensingh Medical College, Mymensingh, Bangladesh. Total 100 subjects were included in this study. Among them 50 preeclamptic patients were taken as case and another 50 normal pregnant women were taken as control. Statistical difference was calculated by Student's unpaired 't' test. Biochemical values were expressed as mean±SD. The mean±SD of serum phosphorus levels in case and control group were 2.81±0.79 and 3.40±0.87mg/dl respectively. The difference in mean±SD of serum phosphorus were highly significant (p<0.001) when compared between case and control.

Clinical Profiles and Outcomes of Cytomegalovirus Positive Renal Transplant Patients in Early Post-Transplant Period.

Cytomegalovirus infection can cause increased mortality and morbidity in renal transplant recipient. The purpose of the present study was to observe the clinical profiles and outcomes of Cytomegalovirus positive renal transplant patients in early post-transplant period. This prospective cohort study was conducted in the Department of Nephrology at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from September 2016 to August 2017. Adult patients who had undergone renal transplantation were selected as study population. CMV serology (CMV IgM and CMV IgG) of both donor and recipient were detected before renal transplantation. Cytomegalovirus viral DNA was extracted from both serum by using a commercially available DNA extraction kit and PCR was done by the StepOne™ PCR machine using real time PCR kit in all patient during the early post-transplant period. During this period, sign symptoms of patients with cytomegalovirus infection as well as clinical outcomes were also noted. Total number of 32 patients was included in this study with the mean age of 31.15±11.56 years. Cytomegalovirus was found positive in 11(34.4%) patients and negative in 21(65.6%) patients. Anorexia was the most common presentation which was found in 81.8% cases followed by renal impairment, fever, diarrhea, cough and weight loss which were present in 6(54.5%), 3(27.3%), 2(18.2%), 2(18.2%) and 2(18.2%) cases respectively. The outcomes of cytomegalovirus positive patients in first 6 months after renal transplantation revealed 25.0% patients had cytomegalovirus infection; 6.2% patients had cytomegalovirus disease and 6.2% patients were died. However, 9.4% patients had co-infection in the form of UTI and 6.2% patients had re activation of hepatitis C infection associated with cytomegalovirus infection. Cytomegalovirus was found positive in approximately one third of renal transplant recipients in early post-transplant period. Careful clinical evaluation and appropriate laboratory parameters should be looked over for timely diagnosis and management of these cases.

Changes in Serum Uric Acid Level in Acute Myocardial Infarction Patients.

Myocardial infarction (MI) is one of the dangerous manifestations of coronary artery disease and one of the commonest causes of mortality. This cross-sectional study was carried out in the department of Biochemistry, Mymensingh Medical College in collaboration with the department of Cardiology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh during the period of January 2018 to December 2018. A total of 120 subjects were included in this study. Among them 60 were diagnosed AMI patients denoted as case group and 60 were apparently normal healthy individuals denoted as control group. Biochemical values were expressed as Mean±SD (Standard deviation). Statistical analysis was done by using SPSS (Statistical package for social science) version 21.0 windows package. Serum uric acid determined by enzymatic colorimetric method using the test kit. Among the study groups the mean±SD values of uric acid were 6.61±2.62 and 5.38±1.16mg/dl in case and control group respectively. The analysis showed that, serum uric acid was statistically increased in case group compared with control group. The level of significance was 0.001. Statistical significance of difference between two groups were evaluated by using Student's unpaired 't' test.

Serum Magnesium Level and It's Relation in Predicting Adverse In-Hospital Outcome in Patients with First Attack of Myocardial Infarction.

Acute myocardial infarction (AMI) patients characterize a large proportion of admissions in coronary care unit and their management and risk stratification is of immense importance. Hypomagnesemia is a long-term risk factor for incident of both myocardial infarction and arrhythmia. We assessed whether serum magnesium levels at admission is associated with arrhythmias and in-hospital mortality in patients with acute myocardial infarction (AMI). The aim of the study was to evaluate the prognostic implications of serum magnesium level in patients with acute myocardial infarction. This cross-sectional observational study was conducted in the department of cardiology in Mymensingh Medical College Hospital from October 2017 to March 2019. Total 259 acute myocardial infarction patients were included considering inclusion and exclusion criteria. The sample population was divided into two groups: Group-I: Patients with acute myocardial infarction with serum magnesium ≥1.82mg/dl. Group-II: Patients with acute myocardial infarction with serum magnesium <1.82mg/dl. Serum magnesium level was measured on admission, and the incidence of in-hospital major cardiac events was assessed. In this study mean serum magnesium level of Group-I, Group-II were 2.21±0.14mg/dl, 1.60±0.15mg/dl respectively. It was statistically significant (p<0.05). In-hospital outcomes of the study group revealed that low risk group patients were uneventful outcome during hospitalization period, they had no any complication. In Group-I patient, 9(4.8%) were developed arrhythmias, 26(13.9%) were developed heart failure, 9(4.8%) were developed cardiogenic shock and 3(1.6%) were died and in Group-II patient, 44(61.10%) developed arrhythmias, 9(12.50%) were developed heart failure, 7(9.7%) were developed cardiogenic shock and 12(16.7%) were died out of them which was statistically significant (p<0.05). Mean duration of hospital stay of the study population according serum magnesium level was in Group-I, 4.27±0.68 days, in Group-II, 5.84±1.05 days which was statistically significant (p<0.05). In conclusion patient with serum magnesium level less than 1.82mg/dl increased the risk of in-hospital arrhythmia and death.

Association of Dyslipidemia with Endometriosis: A Case Control Study.

Endometriosis is a chronic multi-factorial disease characterized by the presence of functioning uterine glands and stroma in any site outside the uterus. Despite the major public health impact of this condition, little is known about their etiologies. Some studies focused on the similarities between the common biological mechanisms underlying the development of endometriosis and atherosclerotic plaques. So, it is possible to hypothesize that same atherogenic risk factors, such as dyslipidemia may play a role in endometriosis pathogenesis. This case-control study was carried out in the department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from September 2018 to August 2019 to investigate the lipid profile in patients with endometriosis and to analyze the association of dyslipidemia with endometriosis. A total of 140 participants ranged between 18 and 35 years of age attending BSMMU were enrolled in the study. The study population was divided into case and control group; the case group consisting of patients with endometriosis and control group comprising of healthy women without endometriosis. Fasting lipid profile of all participants was measured in the department of Biochemistry and Molecular Biology of BSMMU, Bangladesh. Doing student's t-test and Chi square test compared results of both groups. Logistic regression analysis was done to see association of dyslipidemia with endometriosis. Women with endometriosis were found to have significantly higher levels of serum total cholesterol (TC), low density lipoprotein (LDL-C), triglyceride (TG) and significantly lower level of high density lipoprotein (HDL-C) compared to the controls (p<0.05). The mean atherogenic index was significantly higher in case group (p<0.05). This study found an association between dyslipidemia and endometriosis.Women with endometriosis have higher atherogenic index compared to women without endometriosis.

Clinico-pathological Evaluation of Residual Ovary Syndrome: A Cross Sectional Study.

The residual ovary syndrome (ROS) occurs in patients where one or both ovaries are conserved at the time of hysterectomy. It occurs mostly within 10 years of hysterectomy. Residual ovary syndrome usually requires surgery and histology varies from some physiological cysts to benign or even malignant neoplasms. The objectives of the study were to analyze the etiopathology of re-operation for ROS and to find out their clinical presentations. This cross-sectional observational study was conducted in the department of Obstetrics and Gynaecology, BSMMU during a period of 5 years from January 2014 to December 2018. All consecutive patients admitted with residual ovary syndrome (ROS) at the department of Obstetrics and Gynaecology and also in Gynae-oncology department at Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh. Total 40 cases were enrolled according to selection criteria and sampling technique was purposive. The mean age of the study populations was 42.20±7.13 years. All of the study populations were parous except one who was nulliparous. The mean age of hysterectomy was 37.25±6.44 years. The indication of primary surgery by hysterectomy was fibroid in 50% of cases; others were abnormal uterine bleeding, pelvic inflammatory disease etc. After primary surgery majority (77.5%) of the study populations presented with chronic pain with or without dyspareunia and 20% presented with lump in abdomen either symptomatic or asymptomatic. Around half (57.5%) of the patients were presented within 5 years and 82.5% within 10 years of hysterectomy. Per-operative findings of secondary surgery for ROS were mainly extensive peri-ovarian and peritoneal adhesions involving surrounding structures. Among them majority (77.5%) of the cases were presented with various types of cystic and complex masses in the ovaries. Histopathological reports of residual ovary were functional cysts 35.0% (n=14), Corpus luteal cyst 12.5% (n=5), endometriotic cyst 12.5% (n=5), benign ovarian tumours 37.5% (n=15) and malignant ovarian tumour 2.5% (n=1). ROS, usually requires surgery which in most of the cases becomes troublesome due to presence of extensive adhesions with surrounding structures. So, decision is crucial whether to remove or conserve apparently healthy ovaries found at hysterectomy in pre-menopausal women. Moreover decision of hysterectomy in premenopausal women should be taken very judiciously as several medicines are available for conservative management. Usually indications of hysterectomy are benign.

Coumarin improves tomato plant tolerance to salinity by enhancing antioxidant defence, glyoxalase system and ion homeostasis.

Salinity is a severe threat to crop growth, development and even to world food sustainability. Plant possess natural antioxidant defense tactics to mitigate salinity-induced oxidative stress. Phenolic compounds are non-enzymatic antioxidants with specific roles in protecting plant cells against stress-mediated reactive oxygen species (ROS) generation. Coumarin (COU) is one of these compounds, however, to date, little is known about antioxidative roles of exogenous COU in enhancing plant tolerance mechanisms under salt stress. The involvement of COU in increasing tomato salt tolerance was examined in the present study using COU as a pre-treatment at 20 or 30 µM for 2 days against salt stress (100 or 160  NaCl; 5 days). The COU-mediated stimulation of plant antioxidant defence and glyoxalase systems to suppress salt-induced ROS and methylglyoxal (MG) toxicity, respectively, were the main hypotheses examined in the present study. Addition of COU suppressed salt-induced excess accumulation of ROS and MG, and significantly reduced membrane damage, lipid peroxidation and Na+ toxicity. These results demonstrate COU-improved plant growth, biomass content, photosynthetic pigment content, water retention and mineral homeostasis upon imposition of salinity. Finally, this present study suggests that COU has potential roles as a phytoprotectant in stimulating plant antioxidative mechanisms and improving glyoxalase enzyme activity under salinity stress.

Mucosal-associated invariant T (MAIT) cells are activated in the gastrointestinal tissue of patients with combination ipilimumab and nivolumab therapy-related colitis in a pathology distinct from ulcerative colitis.

The aim of this study was to investigate the pathogenesis of combination ipilimumab and nivolumab-associated colitis (IN-COL) by measuring gut-derived and peripheral blood mononuclear cell (GMNC; PBMC) profiles. We studied GMNC and PBMC from patients with IN-COL, IN-treated with no adverse-events (IN-NAE), ulcerative colitis (UC) and healthy volunteers using flow cytometry. In the gastrointestinal-derived cells we found high levels of activated CD8+ T cells and mucosal-associated invariant T (MAIT) cells in IN-COL, changes that were not evident in IN-NAE or UC. UC, but not IN-C, was associated with a high proportion of regulatory T cells (Treg ). We sought to determine if local tissue responses could be measured in peripheral blood. Peripherally, checkpoint inhibition instigated a rise in activated memory CD4+ and CD8+ T cells, regardless of colitis. Low circulating MAIT cells at baseline was associated with IN-COL patients compared with IN-NAE in one of two cohorts. UC, but not IN-COL, was associated with high levels of circulating plasmablasts. In summary, the alterations in T cell subsets measured in IN-COL-affected tissue, characterized by high levels of activated CD8+ T cells and MAIT cells and a low proportion of Treg , reflected a pathology distinct from UC. These tissue changes differed from the periphery, where T cell activation was a widespread on-treatment effect, and circulating MAIT cell count was low but not reliably predictive of colitis.

In Vitro Antibacterial Activity of Ethanol Extracts of Cinnamomum zeylanicum against Pseudomonas aeruginosa.

Cinnamomum zeylanicum as medicinal plants are measured as new resources for preparing elements in the treatment of antibiotic-resistant microbes as alternatives to antibiotics. This study was aimed to evaluate the antibacterial activity of ethanol extracts of Cinnamomum zeylanicum against a Gram-negative bacteria Pseudomonas aeruginosa. This experimental study was carried out in the department of Pharmacology & Therapeutics and department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2017 to July 2018. Evaluation of the in vitro antibacterial activity of ethanol extracts of Cinnamomum zeylanicum against Pseudomonas aeruginosa was performed by disc diffusion method. And also in this study we used broth dilution method to determine the minimum inhibitory concentration (MIC). Ethanol cinnamon extract (ECE) was found active against P. aeruginosa. Zone of inhibition (ZOI) ranged between 6-25mm at different concentration of extracts. The MIC was 0.3g/ml. Cinnamomum zeylanicum showed strong antibacterial activity against a Gram-negative bacteria Pseudomonas aeruginosa. The results may contribute to the development of potential antimicrobial agents for inclusion in antipseudomonal regimens.

Knowledge, Attitude and Practice of Bangladeshi Women towards Breast Cancer: A Cross Sectional Study.

In Bangladesh incidence rate of breast cancer was about 22.5 per 100000 females. Breast cancer has been reported as the highest prevalence rate (19.3 per 100,000) among Bangladeshi women between 15 and 44 years of age. For this prevailing situation a cross-sectional study was designed to assess the knowledge, attitude and practices of community-dwelling women in Bangladesh towards breast cancer at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from July 2013 to June 2014. All female participants attending at outpatient department of BSMMU having age more than 20 years and education at least JSC, purposively selected until the sample size achieved 500. Only applying simple cost free method like self breast examination (SBE) and clinical breast examination (CBE) one can asses her breast. Thereby awareness develops regarding her breast so any mass newly appear can be assessed by the lady herself. Early diagnosis of the breast cancer will reduce the burden of treatment cost, mortality & morbidity. Research and development strategy of the project is to enhance the awareness of the community people about breast cancer prevention. Mean age of the study population was 36.16 years. Regarding education nearly 30% (n=150) of them studied up to Junior School, 16% (n=80) respondents completed masters and above remaining in between. Regarding occupation, almost 60% (n=300) were house wife, 32% (n=160) were service holder and only 8% (n=40) of them were students. Knowledge about common female cancer 60% (n=300) were aware about the cervical cancer, 24% (n=120) mentioned breast cancer, 4% (n=20) mentioned ovarian cancer, and 12% (n=60) don't know anything regarding common women cancer. Knowledge about early symptoms of breast cancer, majority of the respondents 66% (n=330) were aware that mass in the breast is the main symptom, 2% (n=10) mentioned pain in breast, 32% (n=160) mentioned that they don't know anything regarding the early symptoms. About the cause of breast cancer 60% (n=300) mentioned that, they don't know anything regarding the cause of breast cancer, 36% (n=180) were aware that non lactation is a cause of breast cancer. About 4% (n=20) of the study population mentioned others, like due to some ones bad did cancer occur as punishment. Knowledge about risk factor of breast cancer, 65% (n=325) have no idea about the risk of breast cancer, 32% (n=160) mentioned few risk factors which have relation with breast cancer and 3% (n=15) did not mention anything. Regarding diagnosis of cancer breast 72% (n=360) mentioned they don't know anything, 16% (n=80) by doing ultra sonogram of breast, 6% (n=30) mentioned about Mammography and 6% (n=30) MRI & others. Regarding screening for prevention of breast cancer 60% (n=300) mentioned that they don't know anything regarding screening. Thirty percent (n=150) were aware that there is screening method but they are not aware specifically regarding this method and they also not aware that breast cancer is a preventable disease. 10% (n=50) were fully aware about screening method like CBE & SBE. About the cause of not seeking medical advice for prevention of Breast cancer, majority of the respondents 40% (n=200) mentioned expenditure problems, 32% (n=160) they don't have any knowledge about this type of medical advice, 8% (n=40) mentioned communication problems and 20% (n=100) others. Regarding Practice of CBE & SBE 68% (n=340) never practice CBE & SBE, 30% (n=150) occasionally practiced CBE & SBE. Only 2% (n=10) mentioned that they were regularly practicing CBE & SBE.

Extra Skeletal Ewing's Sarcoma Involving Perineum of a Young Male Patient.

Ewing's Sarcoma is the second most common primary malignant bone tumor in children and young adults after osteosarcoma but exceptionally it can arise from extra skeletal sites also. Extra skeletal Ewing's sarcoma is of neuroectodermal origin and usually involves extremities, retroperitoneum and paravertebral regions. No case of extra skeletal Ewing's sarcoma involving perineum is yet reported. A 16 years old male patient admitted to colorectal surgery department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh in July 2015 having swellings in perineum as well as both inguinal regions. The swelling was near to anal verge. FNAC from perineal swelling and inguinal lymph node demonstrate small blue round cell tumor. After operation the tumor size was 5cm×4cm, cell type was malignant round cell arranged in sheet and perivascular forming rosette. Extra skeletal Ewing's sarcoma can be a differential diagnosis of soft tissue tumor arising in perineum.

Interaction of sulfur with phytohormones and signaling molecules in conferring abiotic stress tolerance to plants.

Sulfur (S) is a macronutrient for the plant, which has an immense role in basic plant processes and regulation of several metabolic pathways. It has also a major role in providing protection against adverse conditions. Sulfur-containing amino acids and metabolites maintain plant cell mechanisms to improve stress tolerance. It interacts with several biomolecules such as phytohormones, polyamines, nitric oxide (NO), and even with other plant nutrients, which can produce some derivatives those are essential for abiotic stress tolerance. Different S derivatives stimulate signaling cascades, for the upregulation of different cellular messengers such as abscisic acid, Ca2+, and NO. Sulfur is also known to interact with some essential plant nutrients by influencing their uptake and transport, hence, confers nutrient homeostasis efficiencies. This review focuses on how S is interacted with several signaling molecules like NO, glutathiones, phytohormones, hydrogen sulfide, polyamines, etc. This is a concise summary aimed at guiding the researchers to study S-related plant processes in the light of abiotic stress tolerance.

Ovarian Endometrioid Adenocarcinoma Arising in Endometriosis: A Case Report.

Malignant transformation of ovarian endometriosis was first described in 1925 by Sampson; later on it has been described in extragonadal regions by few authors also. Ovarian endometrioid and clear cell carcinoma are highly associated with endometriosis. Here we present a case of malignant transformation of ovarian endometrioma into endometrioid adenocarcinoma and review the clinical and pathological features of these tumors. A 45-years old infertile woman diagnosed as a case of bilateral chocolate cyst with pelvic endometriosis underwent total hysterectomy with bilateral salpingo-oophorectomy. A solid portion was also identified in the right sided cyst, histology of which revealed a well-differentiated endometrioid adenocarcinoma grade-II with foci of squamous morules and keratin pearls. Her pre-operative CA-125 level was within normal range. Women with endometriosis should be considered at an increased risk for the development of ovarian cancer even with normal CA-125 level.

Response & Side Effects of Injectable Labetalol in Pregnancy Induced Severe Hypertension.

The study was performed to assess the response & side effects of injectable Labetalol in the treatment of pregnancy induced severe hypertension. This interventional study was carried out on 72 patients having pregnancy induced severe hypertension attended in the Department of Obstetrics & Gynaecology, Mymensingh Medical College & Hospital (MMCH), Mymensingh, Bangladesh from November 2009 to October 2010. All patients were treated with intravenous Labetalol 20mg & the dose was repeated at sequential escalating dosages every 15 minutes until a therapeutic goal of systolic blood pressure <160mm of Hg & diastolic blood pressure <105mm of Hg were achieved. Among 72 respondents highest number were observed having systolic blood pressure 160-169 and 180 & above mm of Hg. The mean systolic & the diastolic blood pressure at the initiation of the study were observed 198±13.17mm of Hg & 119±8.6mm of Hg respectively. After use of injection Labetalol mean systolic blood pressure were 138.61±15.43mm of Hg, which is statistically significant (p value <0.001) & mean diastolic blood pressure were 96.18±9.7mm of Hg, which is also statistically significant (p value <0.001). It was observed that majority patients' blood pressure was controlled by 1-2 doses. It was noticed that injection Labetalol controls blood pressure in 80% antenatal cases & 86% postnatal cases. Out of 72 patients 4 cases (5.5%) experienced nausea & vomiting and only 1 case (1.1%) experienced headache. Regarding fetal outcome 48% patients delivered healthy baby, about 31% patients delivered asphyxiated baby & neonatal death were noticed in 4% cases. This study assessing the response & side effects of intravenous antihypertensive drug in the treatment of pregnancy induced severe hypertension shows that Labetalol fulfils the criteria of an antihypertensive drug for this purpose.

Sonographically Detected Non Alcoholic Fatty Liver Disease in Apparently Healthy Adults and Associated Factors.

This hospital-based study was done to see the prevalence of sonologically detected non alcoholic fatty liver disease and associated factors in the apparently healthy adults. Apparently healthy and non alcoholic companions of the patients visiting the Centre of Nuclear Medicine and Ultrasound, Sylhet were subjected to abdominal ultrasonography to see the presence of fatty liver. Demographic features and other relevant data were collected in a semi structured questionnaire to find out the associated factors for non alcoholic fatty liver disease (NAFLD). Total 1019 persons with mean age of 37.23 years were included in the study. Among them 703 (69%) were female and 316 (31%) were male. Out of them 189 (18.5%) persons had sonologically detectable nonalcoholic fatty liver disease. NAFLD was more prevalent in male than female (25.6% vs. 15.4%, p=0.000). In univariate analysis NAFLD were more in male (25.6%) 41-50 years age group (29.3%, p=0.000), over weight (32.3%)/obese subjects (51.4%), businessmen (24.0%), service holders (28.7%), high income group, diabetics (27.0% vs. 18.0%, p=0.000) and hypertensive subjects (43.3% vs. 15.24%, p=0.000). In multivariate analysis, BMI over 23kg/m² (OR 6.683, p=0.000), age >30 years (OR 1.787, p=0.006) and higher income (OR 1.788, 95% CI 0.970-3.293) were independent factors associated with NAFLD. Sonologically detected nonalcoholic fatty liver disease (18.5%) is common in our apparently healthy adults. BMI over 23kg/m² was the most important predictor for NAFLD.

Estimation of Thyroid Hormone in Early Pregnancy and it's Clinical Correlation.

This descriptive cross sectional study was done for the estimation of thyroid hormone in early pregnancy and it's clinical correlation. It was conducted at the Antenatal Clinic of Mymensingh Medical College Hospital, Mymensingh from December 2010 to November 2011. Total 185 cases in early pregnancy were taken purposively and randomly. Among the pregnant women, age ranged from 18-42 years with the Mean±SD age 25.77±4.96 years, the gestational weeks ranged 6±1 to 13±1weeks having Mean±SD 9.06± 2.49 weeks. The gravida ranged from primi to 8th gravida Mean±SD 1.89±1.10. Haemoglobin level ranged from 9.0 to 13.2gm/dl; Mean±SD 10.90±0.99gm/dl. Mean±SD of serum FT4 was 17.77±7.25 and Mean±SD of TSH was 3.95±2.94mIU/L. In present study, 5.40% (n=10) of the respondents had hypothyroidism and 0.54% (n=1) showed hyperthyroidism. The present study showed that, the incidence of hypothyroidism had relatively increased then the reference ranges but not statistically significant. But hyperthyroidism was within the reference range. This study showed slightly higher percentage of hypothyroidism in both ≤30 (4.52%) and ≥30 (10%) years of age groups especially a bit higher percentage in the elderly group. In present study, hypothyroidism was common among women of lower income group. Present study showed a higher percentage of stillbirth &miscarriage among study population. This study showed a relatively higher prevalence of abnormal thyroid function (especially hypothyroidism) in the study population and suggests the routine screening of thyroid hormone in early pregnancy in addition to routine antenatal care.

Role of Serum Follicle Stimulating Hormone, Luteinizing Hormone, Testosterone and Prolactin Levels in Azoospermic Male Partner of Subfertile Couple.

This cross sectional study was carried out in the Infertility Unit, Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU) from January 2011 and June 2013. Eighty one (81) consecutive azoospermic male partner of married couple, aged 20-50 years with at least two years of subfertility and no known endocrinopathy and ejaculatory dysfunction were included in this study to find out their abnormal hormonal pattern. None of them had received any form of treatment within the last 3 months prior to hormonal evaluation. Men with hypertension, recent fever, chemo or radiation exposure were excluded from the study. Eight weeks interval two semen analyses were done in the Andrology Laboratory of above department following standard WHO guideline, 2004. Using standard ELISA technique, serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone and prolactin were measured/assayed/estimated. The results of this study demonstrated that 40 (49.4%) men had normal endocrine pattern against 51 (50.6%) with endocrinopathy. The former may be related to obstructive azoospermia, which needs further analyses. Both the increased FSH (>11.1mIU/ml) and LH (>7.6mIU/ml) were observed in 25 (30.9%) men, only elevated FSH (>11.1mIU/ml) in 9(11.1%), and only elevated LH (>7.6mIU/ml) in 7(8.6%). Low testosterone level (<270ng/dl) was observed in 11(13.6%), low TSH (<0.4µIU/ml) in 1(1.2%) and low prolactin (<2.5ng/dl) in 5(6.2%).

Huge Perineal Tumour: A Rare Presentation of Gastrointestinal Stromal Tumour of Rectum.

Gastrointestinal stromal tumour (GIST) is a relatively rare neoplasm of gastrointestinal tract of which Rectal GIST is uncommon. It produces symptoms of per rectal bleeding or change in bowel habit. Recurrences following curative resection are predominantly intraabdominal, hepatic metastasis occurring at a median 20-25 months following the primary surgery. A 42 years old male presented a huge mass in hypogastrium, the size of which was reduced ofter neoadjuvant therapy for period of 1.5 years. He underwent abdominoperineal resection. He developed recurrences in perineum three times and in thigh at short intervals after primary resection. He also developed liver metastasis. He died two and half years after primary diagnosis. Rectal GIST should be included in differential diagnosis of intraabdominal mass and preoperative diagnosis based on histopathological as well as the immunohistochemical feature of the CD(117) and CD(34). Although complete surgical resection with negative tumour margin is the principal curative procedure for primary and non metastatic tumours, further studies are still needed for the determination of the most effective treatment strategy for patients of rectal GIST.

Study on Neurological Manifestations of Eclampsia & Findings of CT scan of Brain.

This cross sectional study was carried out in the Department of Obstetrics & Gynaecology in Mymensingh Medical College Hospital during the period of January 2011 to December 2012 to evaluate neurological manifestations in eclampsia by CT scan of brain. A total 35 patients with eclampsia were studied, who underwent CT scan of brain in Radiology & Imaging Department of Mymensingh Medical College Hospital. The study patients were divided into two groups, those who had changes in brain on CT scan (Group A) & those who had no changes in brain on CT scan (Group B). Finally the study variables were compared between these two groups. Each selected patient fulfilling the criteria was sent to the department of Radiology & Imaging for CT scanning of brain. In antepartum cases of eclampsia CT scan of brain were done after delivery/ termination of pregnancy. In all cases, CT scan of brain was done within 72 hours of admission. Out of 35 patients total 85.72% had changes in brain on CT scan & 14.28% had no changes in brain on CT scan. Among them 45.72% patients had cerebral oedema, 37.14% had cerebral infarct & 2.86% patients had intracerebral haemorrhage. Comparison of neurological parameters were done & showed that there were statistically significant difference between the two groups regarding headache, visual disturbance, hypereflexia & depression of consciousness. There was no statistically significant difference regarding aphasia & hemiplegia between the two groups. So the CT scan of brain has been useful in demonstrating the lesion of brain in patients with eclampsia & also helpful to evaluate the neurological manifestations in eclampsia.