Background: The loop electrosurgical excision procedure (LEEP) is currently one of the most commonly used approaches to treat high grade cervical squamus intraepithelial lesion confirmed on colposcopic guided biopsy examination. Complications of electrosurgical excision procedure (LEEP) are rare. But in Bangladesh, we have very limited research-based information regarding this issue. Aim of the Study: The aim of the study was to assess the complications of loop electrosurgical excision procedure following treatment of cervical intra-epithelial neoplasia (CIN) 2 and 3. Methods: This descriptive cross-sectional study was conducted in OPD, Gynaecology and Obstetrics Department, Rangpur Medical College Hospital, Rangpur, Bangladesh during the period of July 2011 to June 2012. In total, 75 patients with CIN 2 and/or 3 were enrolled in this study as study subjects. The study was approved by the ethical committee of the mentioned hospital. Proper informed written consents were taken from all the participants before data collection. The criteria for inclusion were colposcopic guided biopsy revealing CIN 2 or 3 whose lesion remains confined to ectocervix. The least amount of power that will effectively perform the electrosurgery should be used, so as to minimize the risk to the patient’s normal tissues and ensure that the excised specimen is inacceptable condition for pathological assessment. Data analysis was done by using statistical package for social science (SPSS) 16 versions. Results: In analyzing the post procedure complications of the participants, we observed that, 64% participants were from vaginal discharge. Besides this 21%, 9%, 4% and 1% cases were found with pain, bleeding, fever and cervical stenosis consequently. Distributing persistence of vaginal discharge, 44% participants taken 5-10 days which was noticeable. Only 5.33% participants had vaginal discharge in between 21-25 days. In distributing persistence of pain, we observed that, 8% participants had taken 30 days to be cured which was the highest number of patients. Within one week, all the patients become free from fever. Cervical Stenosis occurred as a delayed complication during follow up at 9-12 months after LEEP in only 1(1.3%) case and occurred at 270th day. Conclusion: As per the findings of this study we can mention vaginal discharge as the most common complication for the cervical intra-epithelial neoplasia patients by treating loop electrosurgical excision procedure. Besides these, physicians should be aware about the sufferings of patients from pain and bleeding. Finally, we can conclude that, LEEP as an easy safe and acceptable treatment for high grade CIN with high cure rate.

Introduction: Globally cervical cancer is the 4th most common cancer in females after breast, colorectal, and lung cancer. In patients with early-stage cervical cancer (stage IB-IIA) who have undergone radical hysterectomy, postoperative histopathologic features along with clinical staging predict prognosis and are used for planning further treatment. Neutrophil-lymphocyte ratio (NLR) is a nonspecific marker to predict prognosis. This study aimed to evaluate the predictive values of preoperative values of NLR for high-risk surgical-pathological features identification in patients with early-stage cervical cancer undergoing primary radical hysterectomy with pelvic lymphadenectomy. Methods: This cross-sectional study was carried out in the Department of Gynaecological Oncology at Bangabandhu Sheikh Mujib Medical University (BSMMU) between July 2019 and June 2020 to evaluate the relationship of preoperative NLR with surgical-pathological features of cervical cancer stage IB-IIA who underwent primary radical hysterectomy and pelvic lymph node dissection. A total of fifty cervical cancer patients were enrolled in this study. Their clinical and histopathological findings and complete blood count reports were collected and analyzed. Result: The ROC curve revealed NLR was 2.670 (sensitivity 63%; specificity 91.3%; Areas under the curves 0.801). Surgical pathological analysis showed that NLR was linked to lymphovascular space invasion. Sixty-three percent of patients having NLR >2.670 were 17.85 times more likely to have LVSI. Conclusion: The study findings conclude that high pretreatment NLR was linked to lymphovascular space invasion. Thus NLR can be used preoperatively to predict the prognosis of cancer cervix and triage the patients into monovalent treatment- either surgery or chemoradiation.

Introduction: A child is defined as “any human being under the age of 18, unless majority is reached earlier due to the legislation applicable to them. In reality, initial care is also found in multipurpose or adult emergency departments. In France (Seine-Saint-Denis), out of 390 children rescued by the Emergency Medical Assistance Service (SAMU) in 2004, 77% of child deaths were medicalized by the Regional Emergency Medical Service (SMUR). all-rounders of the department. As a result, at the hospital in Mali, many children are referred to the emergency department, while there is no pediatrician in the SAU and the technical platform is not well suited to their care,hence the objective of this work.. Methods and Materials: We conducted a prospective, longitudinal study over a period of 12 months from January 1, 2019 to December 31, 2019 at the emergency department of the hospital in Mali. The study involved patients aged zero (0) to fifteen (15) years The parameters studied were socio- demographic and clinical variables Results: During the study period, we collected 458 children aged 0 to 15 out of 6517 visits to the service, i.e. a frequency of 8.12%. The age group of 10 to 15 years was the most representative with 39% of cases. The male sex represented 58% of cases with a sex ratio of 1.36. The patients were uneducated in 10% of the cases, the workers represented 28.8% among the fathers and 54.8% of the mothers were housewives. Children belonging to families with more than three children accounted for 50.9% of cases and 39.5% of patients lived outside Bamako, the capital. Our study shows that 53.9% of patients were admitted between 8 a.m. and 4 p.m., 54.8% of patients came to the service by taxi, vehicle or motorbike and admissions by referral/evacuation represented 60.3% of case. AVP accounted for 48.7% of cases After the initial examination on admission, 36% of patients were classified as category three according to the Clinical Classification of Emergency Patients (CCMU3). Conclusion: The grounds for recourse of children from 0 to 15 years old to the general-purpose SAU of the Hospital of Mali are multiple. Accidents remain the most frequent reason for recourse in the service.

Introduction: Burns in pregnancy is common in Bangladesh. Burns are a major, global public health problem, resulting in an estimated 195,000 deaths annually. The majority of burns occur in low-and middle-income countries, with almost half occurring in the World Health Organization (WHO) South-East Asia Region. Objective: To assess the maternal and fetal outcome in second and third trimesters of pregnancy with burn. Methods: This is a retrospective study was conducted in Burn and plastic surgery unit Dhaka Medical College Hospital, Dhaka, Bangladesh from March to May 2022. Total 28 patients admitted were included. The data was collected on the basis of age, percentage of burn over the body surface, gestational age, maternal and foetal outcome. All admitted patients having burn with live pregnancy was included in the study and epidermal burn and burn with other severe co-morbidities were excluded from the study group. All patients were informed about the study. Then those patients willing to take part in the study were included. Results: Total 28 patients (3.1% of female burn patient of childbearing age), having burn with Pregnancy were included in this study fulfilling the inclusion and exclusion criteria. Among 28 patients, 10 (35.7%) patients were in age group 15-20 years followed by 11 (39.3%) in age group 21-25 years, 5 (17.8%) in age group 26-30 and 1 (3.6%) patient each was in age group 31-35 years and 41-45 years group. Age range was 16-45years. 96.4% burn Accidental and 3.6% burn Suicidal. Among 28 patients, 16 (57.1%) were survived after treatment and 12 (42.9%) patients died. The causes of death were septicemia and MODS in maximum cases. Fetal outcome shows, 16(57.1%) fetus were survived. Of them 8 pregnancy continued till discharge, 8 babies were delivered during treatment period (6 by normal vaginal delivery, 2 by caesarian section). 12 (42.9%) fetal death occurred. Among them 5 fetus died with maternal death, 1 intrauterine death follower by normal delivery and 1 still birth occurred. Conclusion: Most burns with pregnancy are in the 16-30 years age group and accident was the major cause of injury. Inhalation injury, burn related complications like burn shock, septicemia and infection are major factors responsible for maternal and fetal mortality. Early hospitalization, prompt and aggressive fluid management, proper management of suspected inhalation injury and early identification and management.

Background: Abortion or miscarriage is a common health intervention. Incomplete abortion is a term given to miscarriage where there are retained product of conception still within uterus. Complications of incomplete abortion includes haemorrhage, infection, shock even DIC (Disseminated intravascular coagulation). Treatment of incomplete abortion has traditionally been surgery like D&C or MVA. Though these treatments are effective but they require specialized equipment, trained person and associated with dangers like uterine trauma, perforation, bleeding to instrumentation, infection & reaction to anaesthesia. For these reasons determining an effective nonsurgical approach for treatment of incomplete abortion is important. Materials & Methodology: During the period of June 2021 to December 2022, 100 women diagnosed as incomplete abortion, were selected in Popular Diagnostic Centre (Badda, Dhaka) and in US-Bangla Medical College Hospital (Narayanganj) as per inclusion criteria and treated with Tablet Misoprostol 6ooµg orally and success to treatment was noted. Results: Treatment was found successful in 94% cases. 6% Cases needed MVA. Among 94% cases 32% was successful after 1st dose of Misoprostol and 62% was after 2nd dose of Misoprostol. Conclusions: Oral Misoprostol is very effective method with high patient satisfaction.

Introduction: The International Continence Society (ICS) describes Urinary incontinence (UI) as the complaint of involuntary leakage of urine and proposes a classification according to the existence of signs and symptoms and mechanisms of occurrence [1, 2]. Purpose: The purpose of this review is to find existing evidence based intervention for Stress Urinary Incontinence (SUI) among women. A preliminary search on Cochrane database, PUBMED, EMBASE, SCOPUS & CINHAL done by the researcher and found relevant studies which provided strong evidence to support role of Pelvic Floor Muscle Exercises (PFME) or Pelvic Floor Muscle Training (PFMT) in reducing symptoms among women diagnosed with SUI. Conclusion: The review concluded that PFMT is a feasible and patient friendly exercise program used for treating SUI with high quality evidence and to be followed under supervision of a health professional. It is also found that less number of recent studies hence suggest having long term studies in future.