Introduction: The aim of this study is to understand the perception and representation of believers in the MBATA MAYANGI parish on the premarital medical examination in order to propose strategies to meet the expectations of believers in this church. Method: To carry out this study, we used a phenomenological survey method, supported by the face-to-face semi-structured interview technique and the instrument is the interview guide on a reasoned non-probability sampling of 20 participants. Results: concerning representation, the participants believe that the premarital medical examination does not represent much because it is God who protects, is an obstacle to the marriage of young people today, the premarital examinations are presented as a condemnation, finally, is comparable to the competition for admission to married life. For their expectation on the part of families, they have expectations that they have expressed in the following two ways: Parents must educate their children from an early age on medical examinations and also an awareness of youth on the well-being based on the premarital examination. Conclusion: the Christians of this parish do not have a good perception and do not imagine prenuptial examinations well, hence the need to popularize the importance of these examinations in different Churches.

Introduction: An ectopic pregnancy occurs when a fertilized egg implants and grows outside of the uterine cavity. Ectopic pregnancy usually occurs as a result of delay or prevention in the passage of the blastocyst to the uterine cavity resulting in its premature implantation in the extrauterine tissues. It usually occurs in 2% of all pregnancies and is a major cause of maternal morbidity and mortality when misdiagnosed or left untreated and subsequent successful pregnancy is less than 50% of patients. About 95% of ectopic pregnancies originate in the tubes. Infrequently, it affects the ovary, the bicornuate uterus, and the cervix. The diagnosis of ectopic pregnancy has been performed using laparoscopy. Additionally, it is widely used for the surgical treatment of ectopic pregnancy. The benefit of laparoscopy for ectopic pregnancy over laparotomy is well-known. Laparoscopic surgery has been widely adopted and new technical innovations, procedures, and evidence-based knowledge are persistently emerging. The laparoscopic advantage over open surgery has also been confirmed in different fields. It is associated with shorter operative time, less intraoperative blood loss, reduce postoperative pain, less analgesic requirement, a shorter hospital stay, faster recovery, cost- effectiveness, and lower rate of postoperative complications. This study aimed to compare the outcome of laparoscopic management with laparotomy in the management of ectopic pregnancy. Methods: This was a prospective cross-sectional study that was carried out in a district level hospital at Cox's Bazar. This study was conducted from May 2020 to May 2022. A total of 59 subjects were selected for the study as per inclusion criteria. Result: Among 59 respondents, most of the subjects were of the 15-25 years age group which constituted 81.36%, followed by 13.56% of the 26-35 years age group, and the rest 5.08% were of >35 years age group. Laparoscopy was done on 40 (67.20%) patients and laparotomy was done on 19 (32.80%) patients. Approximately, 25% of laparoscopy patients and 52% of laparotomy patients had prior surgery. Prior ectopic surgery was performed on around 8.47% of laparoscopy patients and 13.55% of laparotomy patients. Regarding the comparison of laparoscopy and laparotomy procedure, total blood loss was less (30-50ml) in laparoscopy and more (≥60ml) in the laparotomy procedure. Hospital stay was also less (1-2 days) in laparoscopy and more (≥3 days) in laparotomy, duration of operation was shorter (20-30min) in laparotomy and comparatively longer (30- 60 min) in laparoscopy. Previous surgery was done on 25% and 52.17% patients who underwent laparoscopy and laparotomy respectively. Previous ectopic pregnancy was diagnosed on 8.33% and 47.83% of laparoscopy and laparotomy patients respectively. Moreover, previous PID was found in 5.55% patients who underwent laparoscopy and none who underwent laparotomy. 2.77% of patients who underwent laparoscopy had a history endometriosis. Recovery to normal activity was early in laparoscopy and late in laparotomy. Moreover, 27 (67.5%) patients conceived among 40 who underwent laparoscopy, and 3 (15.78%) patients conceived among 19 who underwent laparotomy. Conclusion: The management of ectopic pregnancy with laparoscopy may be the most helpful operation with the highest possible level of safety and effectiveness. Laparoscopy has both a diagnostic & therapeutic role in ectopic pregnancy. Laparoscopy is feasible and safer than laparotomy in surgical management of ectopic pregnancy.

Background: Cervical incompetence (CI) is a common cause of mid-trimester pregnancy loss. Clinical evidence has demonstrated the role of cervical cerclage in reducing preterm births alongside engendering successful maternal and foetal outcomes in carefully selected women with cervical incompetence. This study aimed at determining foetal and maternal outcomes in women with cervical incompetence after elective cervical cerclage. Methods: A retrospective analysis of 88 patients who had elective cervical cerclage at the University College Hospital, Ibadan (UCH), Ibadan, Nigeria between January 2015 to December 2017. Data from the case records of these patients were analysed using the Statistical Package for Social Sciences version 22. Descriptive analysis was generated and summarized with the aid of pie chart, bar chart and frequency tables. Chi-square statistic was used in testing for associations between categorical variables. Results: The mean age was 32.5 ± 4.2 years. Most of the women (78%) had cervical cerclage performed between 14 -16 weeks’ gestation. The most observed complication was pre-term contractions (76.2%). Eighteen women (20.5%) had a miscarriage and 50 women (56.8%) had term deliveries. The mean gestational age (GA) at delivery was 34.1 ± 5.8 weeks. Maternal complications, use of tocolytics and duration of hospital stay had a significant influence on the gestational age at delivery (p<0.005). Conclusion: Cervical cerclage is an effective surgical procedure for preventing and delaying preterm births in women with cervical incompetence evidenced by a successful outcome in 56.8% of cases depicted in this study. Its use in a low-income country with high rates of preventable pregnancy wastages cannot be over-emphasized.

A relatively rare congenital malformation, hematocolpos is the progressive accumulation of menstrual blood in the vaginal cavity at puberty. It is often the consequence of a hymen imperforation. It is clinically manifested by cyclic pelvic pain and primary amenorrhea and, more rarely, by a pelvic mass syndrome. The diagnosis is primarily clinical. Ultrasound and magnetic resonance imaging (MRI) are additional tests to confirm hematolcolpos and exclude other associated genitourinary malformations. Treatment consists of a hymenotomy to drain the hematocolpos. The age of discovery of hematocolpos varies from 13 to 14 years. We report a case of hematocolpos secondary to hymenal imperforation diagnosed in a 17-year-old girl with periodic pelvic pain, primary amenorrhea and a pelvic mass. A first ultrasound trap had evoked a large ovarian cyst but the repeat pelvic ultrasound in our hospital confirmed the diagnosis of hematocolpos.

Ovarian non-Hodgkin's lymphoma is an extremely rare tumor. It accounts for 1.5% of ovarian cancers and 0.5% of non-Hodgkin's lymphoma (NHL). It is most often a secondary location of a disseminated lymphomatous disease. We report on a patient managed in the department for this condition.

Introduction: Adenomyosis is a common, estrogen-dependent, a benign gynaecological disease characterized by endometrial glands and stroma invading, implanting, and proliferating within the myometrium to form diffuse or localized lesions. Adenomyosis is common in women of childbearing age. The signs and symptoms include dysmenorrhea, menorrhagia, abnormal uterine bleeding, enlarged uterus, dyspareunia, and infertility, which can seriously affect the patient’s quality of life. The prevalence of adenomyosis varies widely from 5% to 70%, depending on the method used for diagnosis and the rate of diagnosis during hysterectomy is approximately 20– 30%. Aim of the Study: The aim of this study was to evaluate and compare the effectiveness between LNG-IUS and Dienogest among the woman with symptomatic adenomyosis. Methods: This was a randomized controlled trial and was conducted in the Department of Reproductive Endocrinology and Infertility, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka, Bangladesh during the period from July, 2021 to June, 2022. We included 20 patients with symptomatic adenomyosis diagnosis confirmed by transvaginal ultrasound in this study. All patients were divided by sequentially numbered sealed opaque envelops into two groups- Group A (who received LNG-IUS) & Group B ( who received dienogest). Among of 20 patients, 10 were in each group. Group A patients received LNG-IUS and group B patients received tablet dienogest(2mg) daily. VAS (visual analog scale) score, amount of uterine bleeding was assessed and uterine volume was measured by transvaginal ultrasound 3 months later. Result: In total 20 patients from both the groups completed the study. In our study we found majority of our patients (75%) were aged between 25 to 34 years old and 25 % were aged between 35 to 45 years old. We found the Mean ± SD of age was 34.80 ± 3.79 & 28.60 ± 3.17 respectively in group A & B. In group A and group B the mean of VAS at baseline & 3rd month was 9.10 ± 0.84 & 1.10 ± 1.10 and 8.75 ± 1.14 & 4.30 ± 2.41 respectively. At baseline the uterine volume was 268.08 ± 118.28 & 202.32 ± 117.76 and at 3rd month was 210.10 ±105.49 & 202.77 ± 118.33 among group A & B respectively the mean of hemoglobin level was 10.87 ±1.42 &10.82±0.64 at base line and 11.57 ±1.33 & 11.09± 0.53 after 3rd months in group A and group B respectively. Before treatment heavy menstruation was found 80% & 80% in group A & B respectively. After 3rd month correction of heavy menstruation was found 100% in group A. Among them amenorrhea was found 20% and regular menstruation was found 80%. Correction of heavy menstruation was found 50% in group B. Among them amenorrhea was found 20% and regular menstruation was found 30 %. Conclusion: In our study, we tried to evaluate the effects of LNG-IUS and dienogest on patients with symptomatic adenomyosis. We found that LNG-IUS is a useful tool for HMB and dysmenorrhea in women of all ages. In this study the LNG-IUS is proved to be an effective approach compared to dienogest to treat adenomyosis. Its use effectively reduced the severity of symptoms including heavy menstrual bleeding and dysmenorrhoea, uterine volume and improved laboratory outcomes.

Introduction: Eclampsia (Greek, “shining forth”) is an acute and life-threatening complication of pregnancy, and is characterized by the appearance of tonic-clonic seizure, usually in a patient who had developed pre-eclampsia. Pre- eclampsia and eclampsia are collectively called hypertensive disorders of pregnancy and toxemia of pregnancy. This study aimed to analyze the feto-maternal outcome of preterm eclampsia and its relationship with the mode of delivery. Methods: This descriptive type of cross-sectional study was conducted at the eclampsia unit of the Department of Obstetrics and Gynecology, Dhaka Medical College Hospital, Dhaka, Bangladesh. The study was carried out from February 2012 to July 2012. A total of 92 subjects were enrolled in this study as per inclusion criteria. Result: In this study, the prevalence of eclampsia was 10.12%, and preterm eclampsia was 1.31%. The majority of the patients (48.91%) were within 20-25 years of age, and only 1.09% were >30 years of age. Most of the patients were primi gravida (78.26%). The majority of the patients (54.35%) reported within 3-5 hours. Most of the patients came at 33-34 weeks gestation, but quite a significant percentage (30%) came at 28-32 weeks of gestation. A large number of patients delivered spontaneously, a fair number of patients were induced & a few patients required LSCS. In both SVD & induced groups, the majority of the patients (62% & 66% respectively) were delivered within 7-12 hours. In the SVD group, 10% of patients were delivered within 6 hours whereas in the cesarean section group 85% of patients were delivered within 6 hours. Maximum patients (81%) had induction delivery intervals between 7-12 hours. 12 (60%) patients had LSCS done due to fetal distress, 2 (10%) due to previous H/O LSCS, 1 (5%) due to primi gravida with a twin pregnancy, and 5(25%) due to primi gravida with breech presentation. Of patients who presented at 28-32 weeks of gestation, among them 16 had SVD, 11 patients had induction of labor, and LSCS was done in only one case & which was stillborn. The majority of the babies in the SVD & induced group developed asphyxia (81% & 90% respectively) and the majority needed admission to NICU (62% & 73% respectively). PND was also high (>50%) in both groups. Of patients who presented at 33-34 weeks of gestation, 19 had SVD, 15 patients had induction of labor, and only 4 patients required LSCS. A significant number of babies in all three groups (42%, 47% & 100% respectively) were healthy. Although in SVD & induced groups a large number of babies developed asphyxia (58% & 47% respectively) and admission was required in NICU 26% in both groups. PND was few in both groups. For patients who presented at 35-36 weeks of gestation, the majority was delivered by LSCS (15) & outcomes of babies were good in this group as well as in the SVD group. Only one baby developed birth asphyxia. The maternal outcome was good in all three groups (85%, 91%, & 100% respectively). No maternal complication occurred in the cesarean section group. In SVD & induced group few maternal complications occurred such as recurrent convulsion (12% & 13% respectively), CVD (single case in both groups), pulmonary edema (1), HELLP syndrome (1), and septicemia (1). Three mothers die in SVD & induced group. Conclusion: This study concluded that early-onset eclampsia has been associated with worse perinatal outcomes. Gestational age <32 weeks who do not go into labor spontaneously may offer induction, as the cesarean section does not carry any good prognosis to the fetus but rather increases morbidity to the mother. When gestational age crosses >33 weeks, a complete evaluation of the fetal condition, mental condition, and cervix is necessary to plan for the mode of delivery.

Introduction: Infertility is a common issue among married couples in Bangladesh. Infertility is often caused by a combination of multiple factors, and that individual cases of infertility can be complex and difficult to diagnose. Objective: To assess the determinants of infertility among the infertile couples both male and female. Materials and Methods: This prospective observational study was conducted in the Infertility unit, Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, during the period from 01.07.2018 to 30.31.12.2021. Five hundred infertile couples were recruited from the out-patient department of infertility unit who came to take treatment for their infertility problem. Results: Mean (± SD) age of the female patients was 27.1 ± 5.2 years ranged between 18-44 years. Mean (± SD) age of the husband of patients was 34.0 ± 5.9 years ranged between 22-55 years. Primary infertility was seen in 59.8% study subjects and secondary infertility was seen in 40.2% study subjects. In our study, most of the women (94%) had below normal (<3 U/L) serum FSH. Most of the women (96%) had below normal (< 2U/L) serum LH. Serum TSH was normal (0.2 – 4.5 mU/L) in 51.0% patients. Majority of the women (60.8%) had above normal (>21 pml/L) serum FT4 level. Most of the women 72.2% had normal serum prolactin level. In male patients, Testosterone level was above normal (>30 nmol/L) in majority of the patients (73.4%). In Hysterosalpigography (HSG), 0.40% had abnormal uterine cavity, 4.2% had septed uterus, 15.2% had bicornuate uterus, 1.0% had unicornuate uterus and 1.6% had endometrial polyp. Hysteroscopy found abnormal uterus in 1.2% of patients, abnormal uterine cavity in 11.4%, abnormal endometrial flakes in 12.4%, abnormal right ostium in 13.0% and abnormal left ostium in 12.6%. Intrauterine adhesion, polyp and submucus fibroid were found in 35.2%, 2.8% and 17.6% respectively. Laparoscopy found abnormal uterus in 3% patients, abnormal right fallopian tube in 33.2%, abnormal left fallopian tube in 34.2%. Also, abnormal right fallopian tube in 37.0% and abnormal left fallopian tube in 37.6%. Pouch of Douglas free was found in 63%. During dye test in laparoscopy, 57.6% patients were found positive. In quality, semen type was found poor (<4%) in majority (61%) of the husbands. Regarding semen count, above normal (>20 million/ml) level was found in majority of the patients (80.8%). Regarding semen quality, majority (96%) had oligospermia (<15 million/ml). In case of rapid linear (RL), normal (50-60%) level was seen in majority of the patients (81.6%). In case of slow linear (SL), below normal (<15%) was seen in majority (64.8%) of the patients. Regarding non-propagative (NP), normal (0-10%) level was seen in most of the (87.8%) patients. In case of morphology of sperms, above normal (>50 million/ml) level was seen in most of the patients (80.6%). Conclusion: This study shows that a significant percentage of both male and female are suffering from infertility. The major causes of male infertility are partly hormonal, structural abnormalities of male genitalia, infection of genital tract, and partly psychological. Causes of female infertility are mostly hormonal, structural abnormalities of the uterus, fallopian tubes, infection of the genital tract and partly psychological.