Introduction: Cervical cancer, a significant public health issue, necessitates reliable diagnostic strategies for early detection and management. In the pursuit of effective cervical cancer screening strategies, the integration of colposcopy and HPV-DNA testing is critical, especially in high-risk populations. The study evaluates the diagnostic efficacy of these methods in patients presenting with symptoms indicative of potential cervical malignancy. Methods: This prospective observational study was conducted at the Department of Obstetrics and Gynecology, President Abdul Hamid Medical College and Hospital, Kishoreganj, Bangladesh. The study included a total of 82 participants collected over a 1-year period from July 2022 to June 2023 following the inclusion and exclusion criteria. Patients with VIA Positive diagnosis, abnormal pap-smear results, contact or abnormal per-vaginal bleeding, foul-smelling per-vaginal discharge, and an unhealthy cervix were included in the study, while currently pregnant women, nulliparous, and postmenopausal women, patients with cervical or vaginal growths, and non-cooperative patients were excluded from the study. Result: The mean age of participants was 36.51 years, with most marriages occurring at an average age of 17.07 years. The study identified a high prevalence of multipara status (50.0% had 2-3 children, 36.6% had more than 3). The majority of first deliveries occurred between ages 16 and 22. A significant correlation was found between age and parity (r = .502, p < .01), and a strong association between age of marriage and age at first delivery (r = .815, p < .01). HPV-DNA positivity was 7.3%, while abnormal colposcopy findings (CIN I-III) were observed in 40.7% of cases. Negative correlations were observed between age of marriage and colposcopy findings (r = -.308, p < .01). Conclusion: This study underscores the importance of age, marital history, and parity in the context of cervical cancer screening. The low HPV-DNA positivity rate compared to the higher incidence of abnormal colposcopy findings suggests the need for a combined diagnostic approach. The findings advocate for tailored cervical cancer screening strategies that integrate both colposcopy and HPV-DNA testing, especially in resource-limited settings.

Unassisted home birth exposes mother and child to the most harmful complications. These complications are identified as one of the main causes of maternal and neonatal morbidity and mortality. Goal: To study the factors favoring home births in the Monisso health area. Method: Descriptive cross-sectional study in the period from January 1 to December 31, 2020 in the Monisso health area. Results: The proportion of home births was 80% (N= 210). The reasons given were respectively: the brevity of the labor of delivery (31.55%), the lack of financial means (25.60%), socio-cultural reasons (23.21%), the long distance between the village and the CSCOM (12 .5%), the high cost of delivery costs in the health center (6.55%). Conclusion: Home births are still very common in rural areas, particularly in developing countries.

Cervical cancer occurs due to Infection by high-risk human papillomavirus (HPV) and subsequent integration of the HPV genome into the host chromosome of cervical epithelial cells. The viral proto-oncogenes, mainly E6 and E7, are responsible for the initial changes in the epithelial cells of the transformation zone of the cervix. The viral proteins inactivate two main tumor suppressor proteins, p53, and retinoblastoma (pRb). Inactivation of these host proteins disrupts both the DNA repair mechanisms and apoptosis, leading to rapid cell proliferation. Cervical cancer is the 4th most common cancer among women worldwide, it ranked 14th among all cancers worldwide. There are 500,000 new cases of cancer of the cervix annually, and about 250,000 mortalities all over the world from cervical cancer. About 80% of all these cases occur in low-income countries. In Nigeria, there are 12,075 new cases of cervical cancer and 7,968 deaths due to cervical cancer per year. The study was a cross-sectional type aimed at exploring the knowledge of the participants on cancer of the cervix and their attitude toward cervical cancer screening using a semi-structured questionnaire in FMC Nguru. Results: The total number of participants was 29(n=29). The mean age of the respondents was 20.9 +/-2. 8SD. Concerning the knowledge of cervical cancer among the participants, 27(93.1%) heard of cervical cancer. Most of the respondents do not know the cause of cervical cancer, as only 10(34.5%) know that cervical cancer is associated with HPV. The risk factors for cervical Cancer are not known by most of the respondents as 14(48.3%) agreed that having a relative who had the disease is a risk factor, while only 10(34.5%) agreed that HPV is a cause of the pathology. There was poor knowledge regarding the presentation of cancer of the cervix, abnormal vaginal bleeding is the most popular way of presentation known by 13(44.8%) of the respondents while only 8(27.6%) know that cervical cancer can present with bleeding after sexual intercourse, five of the respondents (17.2%) showed smelling vaginal discharge as the mode of presentation, dysuria by only 2(6.9%). A good number of the participants know about cervical screening 26(89.7%). Twenty-eight respondents (96.6%) are willing to go and have themselves screened for cervical cancer if they are asked to do so, and 27(93.1%) will advise some other people to go for the screening. A good number of the respondents, 27(93.1%) are aware that cancer of the cervix can be prevented. Conclusion: The students had a good awareness of cervical cancer and cancer of the cervix screening and had a positive attitude toward having themselves screened whenever the chance was available, and also had a positive attitude toward being willing to convince other people to go for the screening, but demonstrated less knowledge on cervical cancer causes, risk factors and mode of presentation. Hence there is a window of opportunity to deliver more health education to the students and by extension to the larger population.

Background: Lots of religious beliefs and doctrines among clergy in Christianity, Islam and traditional worshippers have determined the outcome of pregnancy and health of pregnant mothers in developing countries making them occasionally go through unnecessary risks of childbirth and postpartum conditions. Hence, a study to assess the influence of belief of religious leaders on the acceptance of Caesarean Section as a choice of child delivery is paramount. Methods: A cross-sectional study was conducted in April, 2023 among religious leaders and a total of 422 of them were selected randomly and interviewed using a structured interviewer-administered questionnaire. Results: About 164(38.9%) were below 40 years, 272(64.5%) were males, 150(35.5%) were females; majority 273(64.7%) practice Christianity, 138(32.7%) practice Islam; 354(83.9%) belong to the Yoruba ethnic group; more than half of the respondents 293(69.4%) were married; 314(74.4%) had a nuclear family structure; majority 302(71.6%) had tertiary education; 186(44.1%) were employed, 168(39.8%) were self-employed. 372(88.2%) believed that Caesarean sections a method of child delivery; less than half 144(34.1%) believed that Caesarean section is only used for emergency; 151(35.8%) believed that Complications of caesarean section are more than normal vaginal delivery; 198(46.9%) believed that Caesarean section is an easy way of delivery; 82(19.4%) believed that Caesarean section benefits only the mother; 80(19.0%) believed that Caesarean section affects the bonding between mother and child; amongst others. Conclusion: The study reveals that religious leaders in Ogbomoso will require more scientific information about caesarean section, and a significant proportion of them hold misconceptions about the procedure. Nevertheless, the majority of the religious leaders in the study were willing to accept caesarean section as a mode of delivery. Given their role in influencing their members' health-seeking behaviour, religious leaders could play a significant role in improving maternal and child health outcomes in the community by promoting accurate information about caesarean section and encouraging its acceptance.

In our article, we report the case of a patient with metastatic endometrial cancer whose risk factor was an intrauterine device worn for over ten years.

Background: Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder affecting 5-10% of women worldwide, characterized by irregular menstrual cycles and cysts on the ovaries. Its exact cause is unknown, but early identification and intervention can reduce the risk of complications like diabetes and heart disease. PCOS manifests in various ways, impacting reproductive, cosmetic, metabolic, and psychological aspects. Prevalence is higher in certain ethnic groups, and diagnosis can occur in adolescence but is often delayed. Despite its global impact, most studies focus on developed countries. Aim of the study: The study aims to explore the diagnosis and treatment procedures for managing adolescent PCOD in Bangladesh. Methods: This study, conducted at the Holly lab hospital &Missionary Hospital Brahmanbaria, Bangladesh. The study spanned one year from January 2023 to December 2023. Diagnosis relied on clinical and biochemical evidence of hyperandrogenism and persistent menstrual irregularities. A one-on-one interview gathered comprehensive medical information. Inclusion criteria covered females aged 10 to 19, while exclusions involved specific medical conditions and ongoing treatments. Statistical analyses using SPSS included expressing variables and logistic regression to identify metabolic syndrome risk factors. The significance level was set at p ≤ 0.05 for statistical relevance. Result: The study involves 107 adolescent participants with Polycystic Ovary Syndrome (PCOD). Most were aged 10-15 (55.14%) with an average age of 16.8. BMI analysis showed high prevalence of overweight (29.70%) and obesity (39.40%). Abdominal obesity was normal in 76.60%, while 20.00% were pre-hypertensive, and 3.40% had hypertension. Glycemic status varied, with 76.00% normoglycemic, 21.10% prediabetic, and 2.90% diabetic. Dyslipidemia was present in 90.90%, and metabolic syndrome in 42.30%. Biochemical hyperandrogenism was observed in 33.70%. PCOD features included hirsutism (94.90%) and menstrual irregularities (oligomenorrhea 87.85%). Ovarian morphology showed diverse patterns. Hyperandrogenism, ovulatory dysfunction, ovarian morphology, and metabolic factors were primary contributors to PCOD diagnosis. Treatment approaches varied, including classical interventions (34.58%), lifestyle changes (14.95%), combined oral contraception (12.15%), and antiandrogens (7.48%). Therapeutic treatments included N-acetylcysteine, Inositol, Vitamin D supplementation, and Chromium supplementation. Conclusion: Managing adolescent Polycystic Ovary Syndrome (PCOS) is challenging due to the high prevalence of metabolic complications. Diagnostic complexity emphasizes careful evaluation to prevent premature labelling and psychological stress. Treatment involves lifestyle interventions, hormonal contraceptives, and anti-androgen medications. Standardized diagnostic criteria and a multidisciplinary approach are crucial. Early intervention and continuous monitoring are essential for mitigating long-term health risks. Further research on PCOS in diverse populations is recommended for tailored interventions and a nuanced understanding.

Background: Hypertensive disorders of pregnancy are a significant contributor to maternal mortality, with early identification of risk factors being crucial for proactive management. This study explores the potential of mid-trimester maternal serum β HCG levels as a predictive marker for hypertensive disorders during pregnancy. Objective: The primary objective of this prospective study was to evaluate the clinical utility of second-trimester serum β HCG levels in predicting the development of hypertensive disorders during pregnancy. Methods: The study, conducted from June 2020 to July 2021, recruited pregnant women aged 13-20 weeks who were normotensive and non-proteinuric. Data from 100 respondents were collected, with 50 in each group (Group A with β HCG > 35000 m IU/ml and Group B with β HCG < 35000 m IU/ml). Statistical analysis was performed using SPSS 24.0, and the significance level was set at p < 0.05. Results: Group A had a significantly higher proportion of hypertensive disorders compared to Group B (38% vs. 10%, p < 0.001), with Group A being more than five times as likely to develop hypertensive disorders (cOR = 5.5, 95% CI: 1.862, 16.344). Serum β HCG levels in respondents with hypertensive disorders (Mean = 60626.88 m IU/ml) were significantly higher than those who were normotensive (Mean = 32812.18 m IU/ml, p < 0.001). Sensitivity was 79.17%, specificity was 59.21%, and positive and negative predictive values were 38% and 90%, respectively. Conclusions: Mid-trimester serum β HCG levels are an efficient non-invasive predictor of hypertensive disorders during pregnancy. With its high sensitivity and negative predictive value, this cost-effective test can aid in the early identification and proactive management of at-risk pregnancies.

Background: Post-partum hemorrhage (PPH) is a common complication, seen following 2-4% vaginal deliveries and 6% of caesarean sections. 35% of maternal mortality worldwide (1) and 38% of maternal mortality in India can be attributed to PPH. Material and Methods: Women who had B/L IIAL over a period of 1year 2021 at Dr. VVP Pravara Rural Hospital, Loni were reviewed retrospectively. Patients were identified using hospital records and operation theatre registers. Clinical history, routine blood investigations, patient demographic data including age, parity, mode of delivery and surgical outcome with complications of procedure were noted. Results: A total of 30 PPH deliveries were conducted during the year 2021. most common indication for B/L IIAL was PPH, seen in 26 out of 30 cases (86.6%) followed by 3 cases of placenta accreta spectrum (1%) and 1 (0.3%) with gynecological complication. Of the 30 cases requiring B/L internal iliac ligation, 9 (30%) were primigravida, 3 (10%) second gravida and 18 (60%) multiparas with 2 or more prior deliveries. Of the 5 cases further requiring obstetric hysterectomy, 2 were second gravidas and 2 multiparas. Conclusion: The ligation of the internal iliac artery as a procedure to stop pelvic hemorrhage is not practiced as commonly as it should be. However, it is safe and effective method to control massive pelvic hemorrhage in experienced hands.

Choriocarcinoma belongs to one extreme of molar pregnancy, the other end is hydatidiform mole. It is a fast-growing tumor that occurs in a woman’s uterus but can easily metastasize to the lungs, liver, and brain. The abnormal tumor cells start in the tissue that would normally become the placenta. Choriocarcinoma developed after a normal pregnancy in 1 in 50,000, miscarriages in 1 in 15,000, and complete mole 1 in 40. The tumor may mimic uterine fibroid, especially when it presents as a uterine mass (which is not the common presentation) posing an initial diagnostic dilemma, as seen in our patient. The patient was an 18years P0+1 whose last normal menstrual period was a year before presentation. She presented with a history of loss of 14-week conception, then followed by 11months history of abnormal scanty vaginal bleeding lasting 21-27 days monthly, the patient was found to be mildly pale but had stable vital signs, she had a uterine mass of about 22weeks size, abdominal ultrasound scan revealed uterine fibroid. In the process of investigation serum pregnancy test was done and was found to be positive, with markedly elevated serum beta hcg. We made an assessment of choriocarcinoma and we commenced her on chemotherapy, she received 4 courses but with no decline in beta HCG. She had a total abdominal hysterectomy and histology confirmed choriocarcinoma, serum beta HCG was then immediately noticed to decline, she had further chemotherapy, and the patient did well subsequently. Huge choriocarcinoma may be mistaken for uterine fibroid, hence a high index of suspicion for choriocarcinoma is important if a patient presents with a recent history of miscarriage, uterine mass, vaginal bleeding, and a positive pregnancy test.