Abstract: Infertility is more of a social problem rather than a medical problem. The term “subfertility” used to describe any form of reduced fertility that results in a prolonged duration of unwanted lack of conception. The difficulty to conceive or subfertility constitutes a major social and psychological burden amongst couples especially in lower-middle country like Bangladeshi women. Accurate and precise diagnosis is mandatory prior to management of case. Although there are many diagnostic tests available, the clinical presentation of each patient can usually be linked to specific and efficient testing strategies. Ultrasonography is an accurate and reliable test for evaluation of subfertilty. Ultrasonographic imaging is easy to use, safe, and readily available noninvasive means to evaluate fertility potential. The purpose of the study is to evaluate and correlate the clinical findings with ultrasonography finding of the subfertile female patient. A hospital based cross sectional study conducted Department of obstetrics & Gynecology (Infertility unit), Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka. Sample was selected from the population by Purposive sampling. All subjects were subfertility in reproductive age group. Total 50 patients were enrolled for study after fulfilling inclusion and exclusion criteria Detail demographic data were collected from the patients and recorded in structured case report form. All collected questionnaire checked very carefully to identify the error in the data. Data processing work consist of registration schedules, editing computerization, preparation of dummy table, analyzing and matching of data. Maximum numbers of patients (62.0%) were between 20-30 years age group with mean age was 26.47 ± 11.57 years. Detailed history taking, examination suggested that, etiology for subfertility were (14%) for tubal factors and (26%) ovarian factors. Clinical and pathological factors for subfertilty were verified by pelvic ultrasonography in all the cases. In case of female infertility, uterine factors account for 32% of the cases. Among the uterine causes, fibroids or myomas in the uterus found (16%) cases, endometrial thickening (10%), endometrial polyp and endometriosis (6%) cases. Ovarian factors like polycystic ovary syndrome (PCOS) found (18%) cases. In 24% of women, USG tests were normal and there is no easily identifiable cause for infertility. Subfertility is not an uncommon problem in our country, major social, personal and economical burden. When pregnancy is considered such an important event in life, and considered a “socially unacceptable condition”, it can lead to a search for treatment appropriately and accurately. Aetiology of infertility are numerous and presentation also variable, sometimes confusion occurs regarding the actual diagnosis and thus delay the prompt management which may result in poorer clinical outcome. Therefore proper clinical evaluation with sonographic and other pathological findings correlation, interpretation helps to proper diagnosis, treatment and prevention as well.

Abstract: Schwannoma is a tumor developed at the expense of Schwann cells. It is a very rare tumor both by its frequency and its retroperitoneal location. Varied presentation and difficult preoperative diagnosis. Although the vast majority of schwannomas are benign, there are malignant forms frequently associated with Von Recklinghausen's syndrome. Its diagnosis is histological and its surgical treatment consists of a complete excision of the mass due to a tumor degenerative risk. We report a case of a 59-year-old patient, followed for chronic pelvic pain associated with digestive signs, ultrasonography and scanner showed a pelvic retroperitoneal mass of 8x6 cm long axis. Exeresis was performed by laparotomy. The histological and immunological study concluded to a benign schwannoma. The clinical and paraclinical evolution over 5 years did not show local or distant recurrence. Through a review of the literature we recall the frequency, diagnosis, imaging data, treatment and evolution of this rare tumor.

Abstract: Obstetrics patients may require intensive care at any time unpredictably. The most common causes of morbidity and mortality in these patients are anaemia, hemorrhage, hypertension, pre eclampsia, eclampsia, septicemia and their complications. The aim of this study was to evaluate the incidence, occurrence, indications, course of ICU stay, interventions required and the outcome of those obstetric patients admitted in the ICU. It was a hospital based, retrospective study conducted in a tertiary care medical college in Haryana, in North India over a period of 2 years – from January 2015 to January 2017. Out of a total deliveries of 7150, 165 patients required ICU admission and care (2.30 %). Most admissions were in the post partum period – 95(57.57 %), followed by antepartum period – 70 (42.43 %). Most common indications for ICU admission were obstetric hemorrhage – 50 (%), eclampsia -17(%), pre eclampsia- 8 (%), septicemic shock – 23 (%), HELLP syndrome – 16 (%), DIC- 10 (%), cerebral malaria-10 (%), dengue-7 (%), hepatic encephalopathy-5(%). The most common interventions warranted were artificial ventilation-139 (84.24 %), transfusion of blood & blood products-140 (84.84 %), surgical exploratory laparotomy – 35 (21.21 %) and there were 15 maternal deaths (9.09 %).

Abstract: Bladder exstrophy is an anterior midline defect. Women with bladder extrophy are fertile and able to have children without this disease. However, Patients undertaking pregnancy after surgical repair of such an anomaly are rare. Pregnancy is often complicated. We report in this work the case of a 24-year-old pregnant patient, operated at birth for bladder extrophy, presenting at 28 weeks of amenorrhea for premature rupture of membranes with uterine prolapse.