Polycystic ovarian syndrome (PCOS) is a complex endocrine disorder characterized by hormonal dysregulation, metabolic disturbances, and reproductive abnormalities. Probiotics are the gut bacteria which helps in digestion and possess several functionalities positively in body like immunomodulation, hormonal balancing, antihypertensive etc. There are evidences pointing for preventive as well as therapeutic results from the PCOS symptoms by administrating probiotics to the adolescent women. Some triggers causing implications of gut microbiota alterations in PCOS, including modulation of host metabolism, inflammation, insulin resistance, and reproductive function. Present paper reviews the mechanism through which these outcomes are achieved.

Background- Anaemia is one of the common health issues that pregnant women and children in developing countries face. Anaemia in pregnancy is related to poor fetal and maternal outcomes contributing to significant morbidity and mortality. Anaemia is a treatable and preventable condition. Aim - to determine the prevalence of anaemia among pregnant women visiting the ANC clinic in a tertiary care centre. Materials and methods- Total 100 pregnant women visiting the ANC clinic in a tertiary care centre were included in the study during the period of 5 months (December 2023 to April 2024) at VVP rural hospital, Loni. The World Health Organization's diagnostic criteria for anaemia was applied for determining hemoglobin levels. Demographic details and hemoglobin levels were collected. Data collected was analyzed using Microsoft Excel 2013 and pspp version 1.0.1. Results- Out of total 100 participants, 51 were anaemic. Out of them, 30 (58.8%) women had mild anaemia, 19 (37.3%) women had moderate anaemia and 2 (3.9%) women had severe anaemia. Mean age of women with Anaemia was 23.3 years as opposed to mean age of women without anaemia which was 26.7 years. Out of 51 cases, 10 (19.6%) women were primigravida, 32 (62.7%) women had birth spacing of less than 2 years, 9 (17.7%) women had birth spacing of 2 years or more. Conclusion- Prevalence of anaemia in our study was comparable to NFHS-5 data. There is need of antenatal and pre-conceptional health awareness about implications of anaemia, preventive measures and spacing between births which will reduce prevalence of anaemia, thus maternal and fetal morbidity and mortality.

Background- Contraceptive methods are preventive methods to help women avoid unwanted pregnancies. They include temporary and permanent measures to prevent pregnancy resulting from coitus. Indian women prefer to avoid unwanted pregnancy, but appropriate information which affects the decision of contraception is not accessible to everyone. Preference of contraceptive method/s depends on multiple factors. Aim- to study the preferred method of contraception among women of age 18 to 30 years attending a tertiary care centre. Materials and Methods- The cross-sectional study was conducted on 200 married women of age 18 to 30 years attending BVP RMC Loni, Maharashtra. The study duration was of 5 months (December 2023 to April 2024). Pregnant, lactating women were excluded. After taking written informed consent, sociodemographic details and contraception details were recorded. Microsoft Excel 2013 and pspp version 1.0.1 were used for the analysis of the gathered data. Results- Out of 200 participants, only 83 participants were using contraception. Thus prevalence of participants using contraception was 41.5%. Out of those 83 participants who were using contraception, majority i.e 35% participants used traditional method like withdrawal and/or rhythm method, 25% used IUD, 16 % participants preferred OC pills or emergency pills, 8% used combination of any two or more methods, 6% used male condoms, 6% were sterilised, 4% used injectable contraceptive. No participant’s husband had undergone vasectomy. Conclusion - Health education about contraceptive methods is needed. Health and social awareness is needed in men about sharing the burden of contraception.

Background- Blood pressure (BP) ≥140/90 mmHg, taken after a period of rest, on two occasions or ≥160/110 mmHg on one occasion in a previously normotensive woman is labeled as pregnancy-induced hypertension. [1,2] Pregnancy-induced hypertension (PIH) is a pregnancy-specific condition that includes gestational hypertension, pre-eclampsia (PE), and eclampsia (E). It is linked to intrauterine death, abruptio placentae, maternal mortality, and intrauterine growth retardation (IUGR) [3, 4]. Aim - to find the prevalence of pregnancy induced hypertension in women attending antenatal clinic in a tertiary care hospital. Materials and methods- Total 200 pregnant women with a gestational age of 20 weeks or greater visiting ANC clinic were included in the study during the period of 5 months (December 2023 to April 2024) at VVP rural hospital, Loni. Demographic details and blood pressure were collected. Data collected was analyzed using Microsoft Excel 2013 and pspp version 1.0.1. Results- Mean age of participant mothers was 23.2 years. Out of total 200 participants, 15 (7.5%) women presented with PIH (8, gestational hypertension and 5, pre-eclampsia and 2, eclampsia). Mean age of pregnant women presenting with PIH was 29 years as compared to the mean age of pregnant women without PIH which was 22 years. Out of 15 participants with PIH, 10 were primigravida, 8 and 3 were from lower and lower middle class respectively. Conclusion- PIH is still important problem and health education and awareness is still needed especially in rural communities.

Background: Labor pain is intensely severe, often leading to hyperventilation and hormonal releases that can harm the fetus by reducing oxygen supply and causing metabolic acidosis. Effective pain management during childbirth is crucial for both physical and mental health. Various pharmacologic and non-pharmacologic methods are available, with epidural analgesia being a prominent choice. It is widely used in high-income countries, provides substantial pain relief, and benefits uterine contractions and placental perfusion. Epidural analgesia has potential side effects and controversies, such as delayed labor and higher intervention rates. Aim of the Study: The study aimed to examine the impact of epidural analgesia on the mode of delivery. Methods: This observational study, conducted from July 2021 to June 2022 at the Department of Gynecology and Obstetrics in a 250-bed District Hospital in Bagerhat, Bangladesh, included 50 participants divided into two groups of 25 each: Group A (with epidural analgesia) and Group B (without epidural analgesia). Approved by the Ethical Committee, the study included women aged 18-35 years, 37-41 weeks gestation, in labor with regular contractions, at least 4 cm cervical dilatation, and a regular fetal heart rate pattern. Excluded were women with medical or obstetrical complications, uterine scars, or spinal deformities. Data were collected via interviews, observations, and clinical examinations. Result: In this study of 50 participants (25 per group), most women were under 30 years old, with mean ages of 22.4±4.5 and 22.9±5.2 years in groups A and B, respectively. Gestational ages ranged from 37 to 40 weeks, and BMIs were 18.5-24.9 kg/m². Both groups had similar parity distributions. Normal vaginal births occurred in 84% (Group A) and 88% (Group B), with LSCS rates at 4%. Group A had 60% male neonates with average birth weights of 2.86±0.27 kg, and Group B had 56% males with weights of 2.88±0.26 kg. APGAR scores were high in both groups. Conclusion: Epidural labor analgesia is safe and does not increase instrumental deliveries or affect neonatal outcomes, making it a viable pain management option. Obstetric care providers can use this information to counsel women.

Background: Hypoalbuminemia, indicative of malnutrition and illness, is associated with a heightened risk of poor post-operative outcomes, particularly impaired wound healing. Pregnancy, characterized by elevated estrogen levels, may further complicate wound healing processes. Objective: To evaluate the association of serum albumin level with wound healing after a caesarean section. Methods: A cohort of 100 pregnant patients undergoing caesarean section at Dhaka Medical College Hospital was included between January and December 2020. Preoperative serum albumin levels were measured, with hypoalbuminemia defined as < 3.5 g/dl. Patients were categorized into groups of hypoalbuminemic (Group I) and normal albuminemic (Group II). Postoperatively, patients were monitored for 60 days to identify surgical site infections and signs of delayed wound healing. Results: The mean preoperative serum albumin level was 2.57±0.35 gm/dl in group I and 4.2±0.4 gm/dl in group II. The difference was statistically significant (p<0.05) between two groups. Out of 19 patients, 9 (47.4%) developed post caesarean wound infection and delayed wound healing in group I. Out of 81 patients, 7(8.6%) developed post caesarean wound infection and delayed wound healing in group II. The difference was statistically significant (p<0.05) with OR=9.51 having 95% CI (2.52-37.32). The number of post-operative days in hospital was 13.11±6.14 in group I and 3.22±1.41 in group II. The difference was statistically significant (p<0.05) between two groups. A subject with serum albumin (<3.5 gm/dl) had 7.626 (95.0% CI 2.324 to 25.02) times increased risk to develop wound infection and delayed wound healing after surgery. Other variables were not significantly associated with delayed wound healing. Conclusion: Hypoalbuminemia is an independent risk factor for the delay in wound healing. Low serum albumin level correlates well with the development of surgical site infection and delayed wound healing contributed to prolonged hospital stay.

Introduction: Ovarian cancer presents a significant challenge in oncology due to its high mortality rates primarily stemming from late-stage diagnoses. Early detection through reliable biomarkers such as CA-125 and IL-6 is crucial for improving patient outcomes. Aim of the study: This study aimed to compare the accuracy, sensitivity, specificity, and predictive values of CA-125 and IL-6 in detecting malignant ovarian tumors. Methods: A cross-sectional analytical study was conducted at the Department of Gynecological Oncology, BSMMU, and NICRH, Dhaka, Bangladesh. A total of 94 women with suspected ovarian tumors underwent preoperative assessment of CA-125 and IL-6 levels. Receiver-operator characteristic (ROC) curves were utilized to determine optimal cut-off values. Result: In this study of 94 women with ovarian tumors, we evaluated the diagnostic performance of CA-125 and IL-6 biomarkers. CA-125 showed a sensitivity of 83.0% and specificity of 51.2% at a cut-off of ≥89.0 u/ml, while IL-6 exhibited 84.9% sensitivity and 80.5% specificity at ≥9.5 pg/ml. Combining CA-125 and IL-6 improved specificity to 95.1%, maintaining a sensitivity of 77.4%. These findings underscore the potential of biomarker combinations in enhancing diagnostic accuracy for detecting malignant ovarian tumors. Conclusion: IL-6 exhibited higher sensitivity and specificity compared to CA-125 in detecting malignant ovarian tumors. The combined use of both biomarkers improved specificity while maintaining reasonable sensitivity, suggesting their potential utility in clinical practice for early detection and management of ovarian malignancies.

Background: Total Abdominal Hysterectomy (TAH) is a common surgical procedure for treating various gynecological conditions. This study aims to evaluate the demographic characteristics, comorbidities, and clinical indications for TAH at Holy Family Red Crescent Medical College Hospital, Dhaka, Bangladesh. Methods: This retrospective study included all TAH cases performed from January 2018 to August 2019. Data on patient age, comorbidities (hypertension and diabetes), and indications for TAH were collected from hospital records. Descriptive statistics were used to analyze the data. Results: A total of 320 TAH cases were reviewed. The most common age group was 41-50 years (43.13%), followed by patients aged ≤40 years (31.56%). Hypertension was present in 36.25% of the patients, and diabetes was observed in 30.94%. The most frequent indication for TAH was fibroid uterus (55.63%), followed by adenomyosis (18.75%) and post-menopausal bleeding (14.38%). Other indications included ovarian cysts (5.63%), endometrial hyperplasia (5.00%), and pelvic mass (6.25%). Conclusion: The findings highlight uterine fibroids, adenomyosis, and post-menopausal bleeding as the primary indications for TAH, with a significant prevalence of hypertension and diabetes among the patients. Effective management strategies for these conditions and considerations of comorbidities are crucial in optimizing surgical outcomes. Further research into minimally invasive techniques may enhance patient care in gynecological surgery.