Background: Early detection of the nature of the tumor is crucial for the management of patients with ovarian tumor. The type of an ovarian tumor can be determined using serum markers, color doppler USG, and a CT scan. These assist clinicians in diagnosing and managing patients with ovarian tumors, as well as establishing treatment plans. Objective: To compare the accuracy of color doppler ultrasound with CT scan for detection of malignant ovarian tumor. Materials and Methods: It was a cross sectional analytical study that conducted in the Department of Gynecological Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU) and National Institution of Cancer Research & Hospital (NICRH), Dhaka. Total 65 consecutive patients attending at the inpatient department of BSMMU and NICRH with ovarian tumor were enrolled for the study. All the patients were selected by clinically, ultrasonography findings and serum marker (CA 125, CA 199, CEA, Alfa fetoprotein and LDH) study. For all these patients color doppler USG and CT scan were done. Patients then undergo laparotomy with frozen section biopsy and taking the histopathology report as a gold slandered. Level of significance was assumed at p value <0.05. Results: The sensitivity of Color Doppler USG and CT scan are 96.9% and 87.5%, respectively. The specificity of Color Doppler USG and CT scan are 60.6% and 57.6%, respectively and the accuracy of Color Doppler USG and CT scan are 78.5% and 72.3%, respectively. The positive predictive values of Color Doppler USG and CT scan are 70.5% and 66.7%, respectively. The negative predictive values of Color Doppler USG and CT scan are 95.2% and 82.6%, respectively. Conclusion: The results of the Color Doppler USG are compared to those of the CT scan results. Results found that the diagnostic accuracy of color doppler ultrasound and CT scan are almost similar for detection of ovarian tumor whether it is benign or malignant.

Background: Maternal obesity in pregnancy is generally recognized as one of the most common risk factors for unfavorable maternal and neonatal outcomes. Obesity has become a prominent issue in obstetrics practice. Objective: To evaluate the maternal outcomes during labor and the immediate postpartum period in overweight mothers. Materials and Methods: This cross sectional analytical study was conducted on the admitted patients with full term singleton pregnancy in labour in the Department of Obstetrics & Gynecology of Sir Salimullah Medical College and Mitford Hospital from July 2020 to January 2021. A total of 150 pregnant women with full term singleton pregnancy in labour were selected fulfilling the inclusion and exclusion criteria. Informed written consent was taken from each respondent. All data relevant to variables of the study was collected in a data collection sheet. Results: Caesarean section rates were considerably higher in overweight/obese patients compared to the normal weight group (p=0.002). The overweight/obese group had atonic PPH (p=0.04). Macrosomia neonate was substantially higher in the overweight/obese mother group than in the normal weight group (OR=10.09, p=0.009). Overweight/obese individuals had significantly increased rates of low APGAR scores (<7 at 1 minute) (p=0.041). The overweight/obese group had slightly increased rates of intrauterine mortality, stillbirth, and low APGAR score (<7 at 5 minutes), although the differences were not statistically significant (p=0.315, p=0.311, and p=0.190). Macrosomia necessitated neonatal critical care, and moms who were overweight or obese had a 4.03 times higher risk (OR=4.43, p=0.026). The obese neonates had a substantially higher mean birth weight (3.22±0.54 kg) compared to the control group (2.95±0.46 kg). Conclusion: Postpartum pregnancy problems such as atonic PPH have been described in overweight or obese pregnant mothers. Increased birth weight, stillbirth, macrosomia, and NICU hospitalizations were also identified in the overweight/obese population.

Background: Cystic hygroma is a congenital lymphatic malformation frequently associated with chromosomal abnormalities, hydrops fetalis, and high fetal mortality. Diagnosed predominantly in the first trimester, late-detected cases often present severe complications and poor prognosis, particularly in low-resource settings with limited access to advanced diagnostic modalities. Case Presentation: We report the case of a 30-year-old third gravida woman in Bangladesh who presented at over 24 weeks’ gestation with amenorrhea and a prenatal ultrasound indicative of cystic hygroma, pleural effusion, and oligohydramnios. Initial ultrasound findings included a large cystic mass at the fetal neck, pleural effusion, and body hyperflexion, suggestive of fetal hydrops and cystic hygroma. Serial ultrasounds confirmed persistent cystic hygroma, increased pleural effusion, and ascites, alongside declining amniotic fluid levels. Limited access to genetic testing restricted comprehensive diagnostic evaluation. The case highlights the high-risk nature of late-diagnosed cystic hygroma, especially where resource constraints limit available interventions. Conclusion: This case underscores the poor prognosis of cystic hygroma in advanced gestation, emphasizing the importance of early screening, regular prenatal visits, and improved access to genetic counseling and non-invasive diagnostic technologies. Future research should prioritize affordable diagnostic tools for low-resource healthcare environments to support timely diagnosis and management.

Introduction: Twin pregnancies present unique challenges for both maternal and neonatal health. These pregnancies are associated with an increased risk of complications, such as preterm labor, growth restrictions, and higher rates of perinatal mortality. Methods: This prospective observational study was conducted at the Department of Gynaecology and Obstetrics in Dhaka Medical College and Hospital, Dhaka, from January 2008 to December 2008. Total number of cases were 132. Data analysis was done using Statistical Package for Social Sciences (SPSS) version 20.0. A descriptive method was adopted in this study. Result: In this study of 132 twin pregnancies, 1.47% of deliveries were twins. Most patients were aged 20-35 years and multiparous. Preterm births accounted for 40.15%, with 43.93% of pregnancies reaching full term. Common maternal complications included premature labor (50%) and anemia (37.87%). The perinatal mortality rate was 10.98%, with prematurity (40.15%) being the leading cause of morbidity. Most twins had favorable APGAR scores (79.3% at 1 minute, 91.2% at 5 minutes), and birth weights were predominantly between 1.6-2.5 kg. Conclusion: This study concludes that twin pregnancies pose significant maternal and neonatal risks, including preterm labor, anemia, and hypertensive disorders in mothers, as well as prematurity and respiratory distress in neonates. However, the majority of neonates showed favorable outcomes with improved APGAR scores over time. While perinatal mortality was relatively low, proper management and early intervention are crucial in improving outcomes.

Background: Ectopic pregnancy (EP), where a fertilized egg implants outside the uterine cavity, is a significant contributor to first-trimester maternal morbidity and mortality, especially in low-resource settings. Understanding region-specific risk factors, clinical presentations, and management outcomes is critical for developing effective healthcare strategies. Methods: This descriptive cross-sectional study was conducted on 100 patients diagnosed with EP at Monno Medical College and Hospital, Manikganj, Bangladesh from January, 2022 to January, 2024. Patient data, including demographic information, clinical history, risk factors, and management strategies, were collected retrospectively from medical records. Management approaches, including medical (methotrexate) and surgical interventions, were analyzed for effectiveness and patient outcomes using SPSS version 26. Ethical approval was obtained, and all patient data were anonymized. Results: Most patients (30%) were aged 26-30 years, and marital status was significantly associated with EP (p = 0.048). History of PID and previous ectopic pregnancy were reported in 35% and 20% of patients, respectively, with significant associations (p = 0.015 and p = 0.040). Methotrexate was administered in 40% of cases, showing significant success (p = 0.025). Surgical interventions, including salpingectomy and laparoscopy, were performed in 35% and 25% of cases, respectively, and significantly associated with positive outcomes. Tubal preservation was achieved in 55% of patients, while tubal loss occurred in 45%. Complications, such as the need for blood transfusions (15%) and hospital readmission (8%), underscore the critical nature of EP management. Conclusion: This study highlights significant risk factors and clinical presentations of EP in a Bangladeshi population, with effective management outcomes observed for both medical and surgical interventions. Improved diagnostic access and timely intervention are essential to reduce EP-related morbidity and enhance reproductive outcomes in low-resource settings.

Anomalies of the Paramesonephric duct is a group of congenital malformations that occur either from the failure to complete bilateral Mullerian duct elongation, fusion, duct canalization, or resorption of the septum. Septate uterus is the commonest of these anomalies and is associated with adverse pregnancy outcomes especially miscarriages. Metroplasty has been associated with improved pregnancy outcomes with hysteroscopic resection been the preferred approach currently. Open abdominal metroplasty is a useful alternative in low resource set-up or where facilities for hysteroscopy is not readily available or not affordable. The need for this case report is to document the case of a complete uterine septum in a 31-year-old woman with three previous miscarriages who had open abdominal metroplasty and subsequent pregnancy with good outcome.

Background: Gestational Trophoblastic Disease (GTD) encompasses a spectrum of pregnancy-related disorders, ranging from benign hydatidiform mole to malignant choriocarcinoma, and poses diagnostic and therapeutic challenges, particularly in resource-limited settings. The purpose of the study was to assess the clinical presentation and follow-up outcomes of patients diagnosed with Gestational Trophoblastic Disease (GTD). Aim of the study: The aim of the study was to evaluate the clinical presentation and follow-up outcomes of patients diagnosed with Gestational Trophoblastic Disease (GTD). Methods: This descriptive cross-sectional study, conducted at the Department of Obstetrics and Gynaecology, Sir Salimullah Medical College and Mitford Hospital, Dhaka, from November 2012 to November 2013, included 70 GTD patients. Data were collected using a structured questionnaire, analyzed via SPSS, and ethical approval was obtained with assurances of confidentiality and voluntary participation. Results: Among 70 patients with GTD, 55.71% were aged 21–30 years, and 91.43% came from below-average income groups. The most common symptom in molar pregnancies was per vaginal bleeding (55.56%), while persistent mole and choriocarcinoma patients frequently presented with bleeding and lower abdominal pain (52%). A large proportion (77.78%) of molar pregnancies had uterine sizes larger than the period of gestation. Regular follow-up was observed in 74% of patients, and 100% underwent serum β-hCG testing. Most hydatidiform mole patients (80%) achieved remission, while 10% of choriocarcinoma cases resulted in death. Conclusion: Consistent monitoring and early detection significantly improve the clinical outcomes of patients diagnosed with Gestational Trophoblastic Disease (GTD).

Background: Postpartum hemorrhage (PPH) is blood loss of 500 ml or more following birth of the baby. This study aimed to determine the impact of skills development training in the management of postpartum hemorrhage. Methods: It was an observational before-and-after study that was conducted in Paropakar Maternity and women’s Hospital. Training regarding management of PPH was given to 65 doctors from July to September 2020. Pre and post-training analysis of the trainees was done. Utilization of the skills that participants gained during training, and the changes in maternal morbidity and mortality related to PPH in the year prior to the training (year 2019) and after the training (year 2022) were recorded. A Chi square test was done to evaluate the p- value and value of <0.05 was considered significant. Odds ratio was calculated. Krickpatrick four level model was used to evaluate the impact of training. Results: There was a vast improvement in pre and post-training scores (29.5% vs 72.5%). A significant reduction in the rate of blood transfusion (41% vs 17.2% p= 0.0001, OR= 0.29), ICU admission (7%vs 1.7%, p=0.0001, OR=0.20) and peripartum hysterectomy (1.3 vs 0.04%, p=0.03, OR=0.28) was found. Similarly, condom tamponade placement, bimanual compression and application of compression suture increased post-training (67 vs 167, 56 vs 108 and 5 vs 12). Most importantly, maternal mortality due to postpartum hemorrhage dropped from 75% to 0%. Conclusion: The skill development training for health care workers was associated with a reduction in morbidity and mortality in patients with postpartum hemorrhage.

Puerperal hematomas are a rare cause of postpartum hemorrhage. Their adequate management requires expertise and an adapted technical platform. To our knowledge, no case has been published in Mali. We report the case of a 38-year-old woman, multiparous 6th procedure 5th par with 5 living children, evacuated from a community health center located 90 km away, in a state of hemorrhagic shock occurring one hour after a home birth. She was surgically treated for an expansive vulvo-perineal hematoma. This case allows us to draw the attention of practitioners to the seriousness and singularity of this highly morbid pathology.

Background: Preeclampsia (PE) affects 2-8% of pregnancies worldwide, leading to maternal and fetal complications such as abruptio placentae, renal failure, and HELLP syndrome. Objective: To investigate the association between plasma D-dimer levels and the severity of preeclampsia, along with its impact on fetomaternal outcomes. Methods: A case-control study was conducted at Dhaka Medical College Hospital from June 2021 to May 2022, enrolling 100 preeclamptic patients (50 with severe features and 50 without severe features). Participants were between 29-40 weeks of gestation. Exclusion criteria included chronic hypertension, renal/hepatic disorders, diabetes, and fetal anomalies. D-dimer levels were measured from 3 mL venous blood samples. Maternal and fetal outcomes were documented and analyzed using SPSS software. Results: The mean age of patients was 26.62 ± 3.99 years (PE without severe feature) and 27.26 ± 5.45 years (PE with severe feature). D-dimer levels were significantly higher in the severe feature group (2.91 ± 2.14 μg/mL) compared to the non-severe feature group (0.79 ± 0.45 μg/mL; p<0.005). Severe PE was associated with higher rates of postpartum hemorrhage (58.0%), HELLP syndrome (12.0%), abruptio placentae (44.0%), and fetal growth restriction (46.0%). The severe PE group also had significantly lower APGAR scores and higher NICU admissions (42.0%). Elevated D-dimer levels were significantly correlated with maternal and fetal complications, including eclampsia (p=0.020), HELLP syndrome (p=0.011), and fetal growth restriction (p=0.022). Conclusion: Elevated plasma D-dimer levels are significantly associated with the severity of preeclampsia and adverse maternal and fetal outcomes.

Background: Red cell distribution width (RDW), a measure of erythrocyte size variation, has been implicated as a potential biomarker in various malignancies. However, its role in distinguishing between benign and malignant endometrial diseases remains unclear. This study aimed to evaluate the diagnostic utility of RDW and its correlation with disease severity in endometrial carcinoma. Methods: This cross-sectional study included 183 women diagnosed with either benign or malignant endometrial diseases. RDW levels were measured and analyzed for their diagnostic significance. Statistical analysis included independent t-tests to compare RDW values between groups and ROC analysis to determine diagnostic accuracy. Correlation between RDW and FIGO staging was also evaluated. Results: RDW was significantly higher in the malignant group (46.64±6.18) compared to the benign group (43.05±7.03; p < 0.001). A non-significant positive correlation was observed between RDW and FIGO staging (r = 0.031, p = 0.815). The ROC analysis yielded an area under the curve (AUC) of 0.463 (95% CI: 0.374–0.552; p = 0.414). The best cutoff value for RDW was 49.50, with a sensitivity of 17% and specificity of 90%. Conclusion: While elevated RDW is associated with endometrial malignancy, its diagnostic accuracy is limited. However, RDW may serve as a supplementary marker when combined with other diagnostic tools, particularly in low-resource settings. Further studies with larger cohorts are needed to validate these findings and explore RDW’s prognostic value.

Background: Urinary tract infection (UTI) is one of the most prevalent bacterial infections during pregnancy, associated with significant maternal and fetal morbidity if left untreated. The physiological changes of pregnancy, such as urinary stasis and altered urine composition, increase the risk of both symptomatic and asymptomatic UTIs. Early identification and management are therefore crucial. Aim of the study: To evaluate the incidence of urinary tract infections during pregnancy and assess the associated maternal and fetal outcomes in a tertiary care setting. Methods: This prospective study was conducted over two years in the Department of obstetrics and Gynecology, Rangpur Community Medical College Hospital, Rangpur, Bangladesh. A total of 220 pregnant women aged 18–40 years were enrolled, of whom 41 were diagnosed with UTI based on clinical presentation, urine microscopy, and culture sensitivity. Patients were classified as having symptomatic or asymptomatic UTI and were followed throughout pregnancy and postpartum for adverse outcomes. Statistical analysis was performed using SPSS version 26. Result: Among the 41 UTI-positive cases, the highest incidence (60.98%) was observed in women aged 18–25 years and in primigravida patients (56.10%). The majority (58.54%) of infections occurred during the second trimester. Asymptomatic UTI accounted for 65.25% of cases. The most common pathogen was Escherichia coli (36.59%), followed by Klebsiella (24.39%). Adverse maternal outcomes included anemia (26.83%), puerperal pyrexia (24.39%), and abortion (12.20%). Fetal complications included preterm birth (36.59%), fetal growth restriction (14.63%), and perinatal mortality (12.20%). Conclusion: UTI during pregnancy is a frequent and often silent infection, with significant implications for both maternal and fetal health. Routine screening and prompt treatment are essential, especially during the second trimester, to minimize complications such as preterm labor, intrauterine growth restriction, and perinatal mortality.

Background: Endometrial cancer (EC) is a leading gynecological malignancy worldwide, with rising incidence in developing countries. Prognostic factors play a critical role in guiding management, especially in resource-limited settings where molecular testing is not routinely available. Aim of the study: To evaluate clinicopathological prognostic factors influencing recurrence in patients with endometrial cancer treated at a tertiary care hospital in Bangladesh. Methods: A retrospective observational study was conducted on 45 histologically confirmed EC patients who underwent hysterectomy-based surgery. Demographic, clinical, pathological, and treatment-related data were analyzed using SPSS version 26.0. Univariate analysis was performed with Chi-square or Fisher’s exact test, and multivariate Cox regression was used to determine independent predictors of recurrence. Hazard ratios (HR) with 95% confidence intervals (CI) were reported, and a p-value <0.05 was considered statistically significant. Result: The mean age was 54.9±12.4 years; 55.6% were postmenopausal. Most patients presented with stage I disease (77.8%). Significant independent predictors of recurrence included tumor grade 3 (HR 2.75; p=0.039), myometrial invasion ≥50% (HR 3.80; p=0.023), LVSI presence (HR 4.25; p=0.007), advanced FIGO stage III–IV (HR 5.67; p=0.004), and lymph node positivity (HR 3.92; p=0.032). Surgical approach and adjuvant therapy were not significantly associated with recurrence. Conclusion: Advanced stage, high tumor grade, deep myometrial invasion, LVSI, and lymph node involvement are key prognostic factors for recurrence in EC. In low-resource settings, reliance on these clinicopathological predictors is essential for risk stratification and optimizing treatment strategies.

Abū Bakr Moḥammad Ibn Zakriyā Al-Rāzī, a distinguished physician of the 9th–10th centuries, made ground-breaking contributions that significantly shaped the discipline of paediatrics and advanced the knowledge and treatment of infectious diseases. His scholarly works, which include the renowned texts Kitāb al-Hāwi and Kitāb al-Judri wa al-Hasbā, underscore the critical importance of preventive health measures, stringent hygiene practices, and the necessity of implementing age-appropriate treatments tailored specifically for children. Al-Rāzī made a significant distinction between the illnesses that affect children and those that are prevalent in adults, advocating for a therapeutic approach that is uniquely tailored to the specific health needs of the younger population. His ground-breaking monograph, titled Kitāb al-Tibb al-Atfāl, systematically addressed the various aspects of paediatric care, offering insights that were revolutionary for his time. Furthermore, Al-Rāzī's meticulous and detailed descriptions of diseases such as smallpox and measles enhanced the precision of diagnostics, thereby improving the understanding of these conditions and their management. His insightful contributions laid the essential foundations for the evolution of modern paediatrics as well as for the contemporary approach to infectious disease management, influencing several generations of medical practitioners and researchers in subsequent eras.