Background: Ovarian tumour preferably malignant one is the leading cause of morbidity and mortality of women. Despite of advancement in surgical and chemotherapeutic treatment during the last decade, still survival rates are poor mainly due to late and incidental diagnosis. Objective: To find out correlation of raised serum CA -125 level with laparotomy and histopathological findings of ovarian tumours. Methodology: This observational descriptive study was conducted in the department of Obstetrics & Gynaecology in Combined Military Hospital, CMH Dhaka from January 2023 to December 2023 and data collection period of 6 months. Total 30 patients having ovarian tumour diagnosed clinically, by ultrasonography and with raised serum CA125 level were included in the study who underwent laparotomy and diagnosis confirmed by histopathology. Results: Total 30 cases of ovarian tumour with raised serum CA-125 were enrolled in the study. Patient presented with lump in the abdomen 26(86.7%) as the commonest presentation. The commonest tumour was epithelial tumour 22 (73.3%) followed by germ cell tumour 8(26.7%). Serous cyst adenoma (47.4%) was common benign tumour& serous cyst adenocarcinoma was the commonest malignant variety (36.3%). Serum CA-125 level was raised in all cases but highly raised in almost all the malignant ovarian tumour 10(90.9%), among them in poorly differntiated 2(18.2%) cases CA-125 level is markdly raised average is 433.5U/ml, then in moderately differentiated cases CA-125 level is highly raised avgerage is 221.5U/ml. In undifferentiated variety average level of CA-125 is 272.5U/ml. In well differentiated case CA-125 level raised to 69U/ml. And on laparotomy, tumours with malignant features has high serum level of CA-125 (>100U/ml). Conclusion: As serum CA-125 is highly raised in most of malignant ovarian tumour, mainly of epithelial variety and moreover makdly raised in poorly differented ones as well as these tumours are found to have features of malignancy on laparotomy, so we can conclude that raised serum CA-125 is a useful tumour marker for early screening, and as well as it can be used as a marker for assumption of the nature and aggresiveness of ovarian malingnancies. Thus, serum level of CA-125 can be used as a tool for detection of ovarian malignancy at early stage, to reduce the morbidity and mortality of patients, as well as to improve the survivility also to reduce the disease burden of the patient with ovarian tumour.

Utero-cutaneous fistula (UCF) is a rare complication of pelvic surgeries in women. It occurs when there is a fistulous connection between the uterine cavity and anterior abdominal wall. It has been reported following open abdominal myomectomy, surgeries for endometriosis, chronic and granulomatous pelvic infection, poorly performed caesarean section, gynaecological malignancies, complication of the management of placenta accreta spectrum, and foreign body insertion for the treatment of infertility. We present three cases of Uterocutaneous fistulas post open abdominal myomectomies manged medically using high dose intramuscular depo-medroxy progesterone acetate (DMPA).

Background: Manual vacuum aspiration (MVA) is a widely used procedure for the management of early pregnancy loss, primarily in low resource settings. A highly successful analgesic method with few side effects is paracervical block (PCB). This study aims to evaluate the patient’s satisfaction and adverse effects associated with PCB during MVA for early pregnancy loss. Methods: This cross-sectional prospective observational study was conducted at Rajshahi Medical College Hospital, Bangladesh, from January to June 2019. Fifty-two women with early pregnancy loss were included through convenience sampling. PCB administered before MVA; pain, satisfaction, effects assessed systematically. Results: This study found that, 23.07% of patients had a just palpable uterus and tenderness in 88.5%. 73.10% patients presented with active bleeding. The cervical OS was open in 76.93% of patients and in 42.30%, the product of conception was felt. Regarding resuscitation, 73.07% required IV fluid infusion, all needed antibiotics and 23.1% required blood transfusions. Most patients (69.23%) had minimal per vaginal bleeding and the average procedure duration was 8-10 minutes (80.77%). The procedure was reported easy by 86.54% of patients, 7.7% reported discomfort and 88.46% would recommend it to others. Adverse effects included nausea in 1.92%, epigastric pain in 3.85%, and excessive bleeding in 5.77%, which was effectively controlled by pressure. Conclusions: Paracervical block is a safe, effective, and well-tolerated analgesic option for MVA in managing early pregnancy loss. Its minimal adverse effects and high patient satisfaction suggest its routine use in clinical practice.

Background: Post-operative wound infections (POWIs) are a leading cause of morbidity and increase in healthcare costs, especially in low resource settings. The rising prevalence of antibiotic resistance among pathogens also increases the complexity of treatment strategies, highlighting the importance of local surveillance of microbiological and resistance patterns. This study aims to find out the antibiotic susceptibility patterns of gram positive and gram negative isolates from the post-operative wound infections from women undergoing obstetric and gynecological surgeries. Methods: A cross-sectional study was conducted at Department of Obstetrics and Gynecology, Dhaka Medical College Hospital, Dhaka from October 2019 to September 2021. A total of 200 women with post-operative wound infections were purposively selected. Among them, 134 had culture-positive findings. Bacteriological analysis and antibiotic susceptibility testing were performed on isolates following standard microbiological methods. Results: Among the 134 culture-positive cases, 33.6% of isolates were gram-positive, with Staphylococcus aureus being predominant. Gram-negative bacteria accounted for 66.4% of isolates, with E. coli and Pseudomonas aeruginosa equally prevalent (20.9%). Gram-positive isolates showed high sensitivity to piperacillin-tazobactam (91.1%) and sulbactam (53.3%) but were resistant to ceftriaxone (48.9%) and cefixime (51.1%). Gram-negative bacteria exhibited sensitivity to amikacin and meropenem but demonstrated widespread resistance to ceftriaxone and doxycycline. Conclusion: This study describes the diverse microbiological profile and high prevalence of antibiotic resistance in POWIs. Novel antibiotic therapy and strict infection control measures are essential to curb the burden of these infections.

Introduction: Uterine rupture occurs in many pregnancies. The risk is higher for women who plan to have a normal birth after a previous cesarean section than for those who have another cesarean section. Objectives: This study aimed to predict the thickness of the lower uterine segment (LUS) by comparing a 2D transvaginal ultrasound with the findings during a cesarean section (C/S) in pregnant women with a history of previous cesarean sections. Methodology: This cross-sectional study was done at the Department of Obstetrics and Gynaecology, at the Institute of Child and Mother Health, Bangladesh from June 2023 to May 2024. A well-structured questionnaire was used for data collection. 100 women underwent transvaginal ultrasound followed by cesarean section (C/S) within a maximum of one week later. Also, an expert gynaecologist classified LUS thickness into four grades in the operation room. Result: The mean age of the women in the study was 30.7 years (±9.62), while the mean thickness of the lower uterine segment (LUS) was 2.25 cm (± 0.55). Among the participants, 43 were classified as grade I for the LUS based on intraoperative findings. The results indicated a significant difference in the mean thickness of the LUS measured by ultrasound across the three grades identified by the gynaecologist (P = 0.04). However, there were no significant differences in maternal age, gestational age, parity, or the time since the last cesarean section among women with different LUS grades (P > 0.05). Transvaginal ultrasound may be useful in assessing the risk of scar dehiscence and uterine rupture in women with LUS grades I and II who have a history of previous cesarean sections. Conclusion: Sonographic lower uterine segment thickness prediction is very important in the study of lower uterine segment thickness after a prior cesarean section to predict uterine rupture. 2D vaginal ultrasonography can be used to assess the risk of uterine scar dehiscence of grades I and II.

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder, affecting an estimated 5% to 18% of women of reproductive age and 3% to 11% of adolescents. The diagnostic criteria for PCOS in adults are not entirely suitable for adolescents, as certain features may represent normal physiological changes during puberty. Ongoing research aims to refine these diagnostic criteria for teenagers. PCOS is linked to hormonal and metabolic disturbances and increases the risk of associated conditions, including obesity, metabolic syndrome, hypertension, type 2 diabetes, and non-alcoholic fatty liver disease (NAFLD). This review was conducted following PRISMA guidelines, employing a systematic search of three major databases: PubMed, Google Scholar, and Embase. Given the high prevalence of PCOS and its potential health complications, it is crucial to identify at-risk adolescent girls early, ensure accurate diagnosis, initiate timely treatment, and promote lifestyle modifications. Current research increasingly focuses on adolescent patients with PCOS. This review aims to explore recent findings on the prevalence, pathophysiology, and diagnostic approaches for PCOS in adolescents.

Introduction: The gender-based violence (GBV) is the set of abuses, means of coercion and physical, sexual, emotional, psychological, economic and educational threats against an individual because of their gender or sexual identity [2]. The objective was to study gender-based violence at the "One Stop Center" unit of Fousseyni Daou Hospital in Kayes. Materials and Methods: This was a descriptive cross-sectional study that was conducted from January 1 to December 31, 2022, a period of 12 months. The study focused on survivors of gender-based violence received for consultation in the "One Stop Center" unit of Fousseyni Daou Hospital in Kayes. The data were collected on a survey form from medical records, the gender-based violence register, requisitions and medical certificates. Data were entered into Microsoft Word 2016 and analyzed using SPSS version 20.0 software. Each survivor had an identification code. Confidentiality and anonymity were respected. Results: During the study period, we collected 79 cases of gender-based violence out of a total of 8,404 cases of gynecological and obstetrical consultations, i.e. a frequency of 0.94%. The most affected age group was 11 to 19 years old with 41 cases or 51.9%. The average age was 16.54 years old and the age limits were 2 and 35 years old. In the profession, children and adolescents not in school were the most represented with 29 cases or 36.7%. Women residing in urban areas were the most represented with 55 cases or 69.6%. Single women were the most represented with 53 cases or 67.1%. Eighty-nine percent of survivors came with a requisition against 11%. Rape was the main reason for consultation with 24 cases or 30.4%. Sexual assault was the most common type of violence with 53 cases or 67.0%. In the sample, we recorded 1 HIV positive case, 2 cases of positive Hbs antigen, 2 cases of positive pregnancy test. There were two cases of surgical management with suture for cases of rape with vulvar lesions and a second-degree perineal tear. Twenty-six cases out of the 79 cases collected were prosecuted. There were about ten cases of conviction. Conclusion: Gender-based violence is a tragedy and can have psychological, physical and even obstetric repercussions in the short, medium and long term because the survivors are mainly fragile minors.