Background: The management of ectopic pregnancy has undergone a revolution in the past few decades. Evidence suggests that the incidence of ectopic pregnancies has been rising. Earlier diagnosis also plays a role by identifying ectopic pregnancies that would have spontaneously resolved. Objectives: The aim of the present study is to describe the presentation and different modalities of management of ectopic pregnancies admitted to the Gynecology ward over the study period. Methods: This was a cross-sectional study was done in the Obs & Gynae Department, Shaheed Suhrawardi Medical College Hospital. Fifty patients who were clinically suspicious of ectopic pregnancy and also supported by positive urinary pregnancy tests, beta hCG and no intrauterine gestational sac in ultrasonography was included for the study. Data were collected in a preformed questionnaire and analyzed by SPSS (version 22.0). Results: Maximum respondents (60.0%) age 21-30 years, mean age 27.71±5.3 years. The past history of pelvic inflammatory disease (PID) forms the major bulk of the risk factors of ectopic pregnancy. Patients had H/O pelvic inflammatory disease was 54% of the study population. Patients had H/O of menstrual regulation 16.0% and history of abortion (spontaneous and induced) 20.0%. Most of the patients 56% having history of < 8 wks. of amenorrhoea, 6% having no history of amenorrhoea and least (4%) having more than 10 weeks amenorrhoea. All (100%) of the patients having history of Abdominal pain; Amenorrhoea was found in (94%), Vaginal bleeding was found in (82%) and general weakness was found in (90%). On the other hand less than 40% had symptoms of fainting attack (36%) and early pregnancy sign-symptoms (38%). Among 50 patients 43(86%) undergone surgical operation,5(10%) receive medical treatment and 2(4%) are managed expectantly, 93.02% cases of ectopic pregnancy occurred in the fallopian tube, 4.6% cornual, 2% ovarian among the study population undergone laparotomy. Right tube was found to be involved more often (55%) than left (45%) and in most of cases (93.02%) the tube was found to be ruptured. Out of 43 cases of laparotomy 37 (86.04%) cases unilateral salpingectomy, 3(6.9%) cases unilateral salpigectomy with contralateral tubectomy and 1(2.3%) cases unilateral salpingo-oophorectomy were done. one case removal of cornu and repair done. Small number of patients had developed minor complications like pyrexia alone 23.25%, Pyrexia with lower abdominal pain (18%), wound gap (2.3%), mild abdominal distension (4.6%), UTI with pyrexia (6.9%) and loose motion (4.6%) among the study population. Conclusion: Pelvic inflammatory disease and multiple induced abortions and menstrual regulations are the strongest risk factors of ectopic pregnancy. Prevention of PID may not only reduce the ectopic pregnancy but also reduce adverse effects on tubal patency. Child birth in total aseptic conditions by a skilled birth attendant to prevent incidence of pelvic infection.

Background: A near-miss obstetric morbidity means a woman who almost died but survived by chance due to any pregnancy related complication. Postpartum hemorrhage has been the leading cause of maternal mortality and morbidity worldwide. The near-miss morbidity due to PPH is an important indicator of maternal care and could be used to compare improvements in treatments more accurately than mortality rate alone. Objective: To evaluate the near miss cases due to PPH in MMCH. Methods: It will be a cross-sectional descriptive study on near miss patients admitted in the Department of Obst& Gynae of MMCH during six months study period. 50 patients will be purposively enrolled according to inclusion and exclusion criteria. Socio demographic character of the patients, clinical presentation, risk factors, mode of delivery, extent of morbidity, amount of blood transfusion, duration of hospital stay, need of ICU support, incidence of peripartum hysterectomy or other surgical interventions will be considered as major variable of the study. Results: Among 50 patients of near miss cases, 21-25 years group belonged to the highest (40%) 30 (60%) patients came from poor class. 32(64%) patients underwent irregular ANC. 27(54%) patients were multipara. 15(30%) had our hospital and 35(70%) patients had delivery in outside hospital. Besides, 27(54%) and 23(46%) patients had vaginal delivery and cesarean delivery respectively. Regarding clinical presentation 17(34%) and 8(16%) patients came with atonic uterus and retained placenta respectively. 32(64%) patients were managed conservatively and 18(36%) patients needed surgical management. 21(40.36%), 9(18%), 8(16%), 5(10%) patients required >3 unit blood transfusion, ICU admission, hysterectomy and laparotomy respectively. Conclusion: 'Near miss' events are important indicators for monitoring the quality of maternity services in health care facilities. Maternal near miss in association with PPH shows better results in case of our hospital managed patients whereas the worse outcome was observed in case of patients who were managed outside hospital.

Infertility is a prevalent medical disease affecting between 8% and 17.5% of couples globally, with a male factor accounting for nearly half of all cases of infertility among couples. Infertility is a reproductive system disorder characterized by the failure to conceive following at least 12 months of frequent unprotected sexual intercourse. It may be primary or secondary in nature. Most countries still struggle to provide equal and fair access to fertility care, particularly in poor and middle-income countries. Hormonal imbalances such as a high prolactin level otherwise called hyperprolactinemia can induce infertility in males. Hyperprolactinemia is a frequent endocrine illness that can cause severe morbidity. It can be caused by a variety of factors, including drug use, hypothyroidism, and pituitary problems. Depending on the origin and effects of hyperprolactinemia, patients require treatment that takes into account the underlying cause, age, gender, and reproductive status. This study examined the biological and metabolic roles of prolactin, as well as the pathophysiological mechanisms and controls that drive male hyperprolactinaemia, laboratory diagnosis, and treatment.

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder linked to insulin resistance, metabolic dysfunction, and hormonal imbalances. Dietary interventions, particularly low- carbohydrate (low-carb) and balanced diets, play a crucial role in managing PCOS symptoms. However, the optimal dietary approach remains debated. Methods: A review of relevant studies, including randomized controlled trials and meta-analyses, was conducted to compare the effects of low-carb and balanced diets on insulin sensitivity, weight management, lipid profile, and hormonal regulation in women with PCOS. Results: Low-carb diets significantly improve insulin sensitivity, reduce fasting insulin levels, and promote weight loss. They may also lower androgen levels and enhance menstrual regularity but raise concerns regarding long-term adherence and nutrient deficiencies. Balanced diets support gradual, sustainable metabolic and hormonal improvements, offering cardiovascular benefits and long- term viability. Conclusion: Both dietary approaches show promise in PCOS management. Low-carb diets yield faster metabolic improvements but pose sustainability challenges, whereas balanced diets provide long-term benefits. Further research is needed to determine individualized dietary recommendations for PCOS management.

Cytomegalovirus (CMV) is the most common congenital viral infection, affecting 0.5–2% of all live births worldwide. Primary maternal CMV infection in the first trimester carries a high morbidity and mortality for the fetus. Herein, we present a case of a 27-year-old primigravida who tested positive for primary CMV infection in the first trimester. The patient experienced fever, fatigue at 8 weeks of gestation. Laboratory investigation revealed elevated inflammatory markers, and CMV serology was consistent with a recent infection (CMV IgM and IgG were positive). She was started on high-dose valacyclovir till amniocentesis then stopped by her self she cannot tolerate and sent for serial fetal evaluations. Fetal CMV was indicated by positive PCR of amniotic fluid at 16weeks. However, ultrasonographic monitoring during pregnancy revealed no structural anomalies other than quarry unilateral cataract at 26weeks. The patient gave birth to a healthy female newborn at term by induced vaginal delivery. Fetal Urinary CMV PCR was positive postnatally. Audiology examination showed bilateral hearing impairment, and the baby commenced on oral valganciclovir. This case highlights the importance of early detection of maternal CMV infection, treatment with antivirals, and the necessity of multidisciplinary antenatal and postnatal monitoring to optimize neonatal outcomes in CMV infection.

Menopause occurs at a mean age of 51 years, with 95% of women transitioning between ages 45 and 55. Declining ovarian estrogen production leads to low serum estradiol and vasomotor symptoms in most women, while approximately half develop genitourinary syndrome of menopause (GSM) characterized by vaginal dryness and dyspareunia [1]. Menopausal hormone therapy (MHT) employs unopposed estrogen for women post-hysterectomy and combined estrogen-progestin therapy for those with an intact uterus to prevent endometrial hyperplasia [2]. This article integrates the latest evidence on indications, formulations, dosing, and safety considerations for systemic and local MHT.