ORIGINAL RESEARCH ARTICLE | Feb. 6, 2021
Histopathological Pattern of Endometrium in Menopausal Women with Postmenopausal Bleeding
Dr. Joysree Saha, Dr. Indrajit Prasad, Dr. Sohana Siddique, Dr. Sumaya Akter, Dr. Md. Mostafizur Rahman, Dr. Shabnam Imam, Dr. Kohinoor Begum
Page no 24-28
Background: Postmenopausal bleeding is generally regarded as an ominous and serious alarm of genital pathologies; represents 5% of all gynecological visits. To develop the treatment procedure of postmenopausal bleeding and to increase the success rate of such treatment, knowledge on the histopathological pattern of endometrium in menopausal women with postmenopausal bleeding is very essential. Aim of the study: The aim of the study was to evaluate various causes of postmenopausal bleeding based on histopathology, and the percentage of various benign, premalignant and malignant endometrial and cervical lesions. Materials and Methods: This was a cross-sectional analytical study which was conducted at OPD, Department of Gynecology and Obstetrics, Popular Medical College, Dhaka, Bangladesh during the period from January 2018 to December 2018. In total 45 menopausal women diagnosed as patients among them 31 patients with postmenopausal bleeding were selected as the study population. Ethical clearance had been taken from the ethical committee of the medical college. All data were processed, analyzed, and disseminated by MS Office and SPSS version 20 as per need. Result: In this study according to the diagnosis report, we found the highest number of participants were with an endometrial polyp and/or chronic cervicitis which was 22.56% separately. No malignancy was seen among 19.35%, Besides these, squamous metaplasia was 19.35%, endometrial adenocarcinoma 9.68%, endometrial hyperplasia with atypia 6.45%, endometrial hyperplasia without atypia 6.45%, papillary adenocarcinoma 3.23% and finally smile cystic change of endometrium 3.23%. Conclusion: Endometrial polyp, no malignancy, endometrial adenocarcinoma, and chronic cervicitis are the most potential endometrial characteristics of menopausal women with postmenopausal bleeding. On the other hand, abdominal pain is the most potential associated symptom of patients with postmenopausal bleeding.
ORIGINAL RESEARCH ARTICLE | Feb. 9, 2021
Association of Lead in Maternal Serum with Fetal Neural Tube Defects (NTDs)
Dr. Fahmida Bayes Kakan, Professor Dr. Firoza Begum, Professor Dr. Nahreen Akhtar, Shamshad Begum Quraisi, Dr. Tabassum Perveen, Dr. Mst. Tajmira Sultana, Dr. Mohammad Saifullah Ahtesam
Page no 29-34
Background: In human birth defects, NTDs account for 0.5-2 per 1000 pregnancies worldwide. It occurs due to abnormalities in neural tube formation. Zinc required for the absorption and synthesis of biologically active folate moiety. Its deficiency creates a lack of folate in metabolic activity. Lead competes with zinc and slowly decreases zinc stores in the body. It causes morphological changes and gives an incomplete blood-brain barrier to the developing nervous system. Objective: The objective of the study was to find out the associations between maternal serum lead concentration and fetal NTDs. Materials and Methods: It was a case-control study conducted in Feto- Maternal Medicine Unit, Department of Obstetrics and Gynecology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from January 2016 to June 2016. Ethical clearance was taken. A total of 60 pregnant women were selected as the study population. 30 with USG detected fetal NTDs case and 30 with normal fetus. In both groups folic acid level was normal. Maternal serum was taken for measuring lead by Graphite furnace automatic absorption spectrophotometer. Data were analyzed by SPPS version 17. Results: The raised value of serum lead was found in 6.67% of patient with fetal NTD. Relationship between NTD and raised value of lead were found significant. Conclusion: From this study, we concluded, raised serum lead level is one of the associated factors for fetal neural tube defects.
ORIGINAL RESEARCH ARTICLE | Feb. 17, 2021
Assessment of Maternal and Perinatal Morbidity and Mortality in Eclampsia by Early Termination of Pregnancy in Bangladesh
Dr. Sabrin Farhad, Dr. Shamima Haque Chowdhury, Dr. Farjana Islam, Dr. Taposhi Rabeya, Dr. Salima Akter
Page no 35-40
Background: Eclampsia is commonly defined as new onset of grand mal seizure activity and/or unexplained coma during pregnancy or postpartum in a woman with signs or symptoms of pre-eclampsia. Objective: The objective of this study was to assess the maternal and perinatal morbidity and mortality in eclampsia by early termination of pregnancy. Methodology and Materials: It was a descriptive observational study conducted in the Department of Gynecology & Obstetrics, Uttara Adhunik Medical College and Hospital, Dhaka, Bangladesh during the period from January 2017 to December 2019. In total 188 pregnant women admitted to the mentioned hospital with antepartum eclampsia were finalized as the study population. This study was approved by the ethical committee of the same hospital. Between the age group, maternal and perinatal outcomes were compared. Data were analyzed using statistical methods with SPSS version 22. Results: In this study 7(9.86%) maternal deaths had occurred among 71 vaginal deliveries. 6(5.36%) maternal deaths had occurred among 112 caesarean deliveries. Besides these, 5 cases were undelivered which all were maternal death. Among 188 cases total of 18(9.57%) maternal deaths had occurred. We did not find any significant correlation between the total number and modes of deliveries of maternal deaths (P=0.581). Among 71 vaginal deliveries, 10(14.08%) stillbirths and 28(39.44%) neonatal deaths occurred respectively; that is why in total 38(53.52%) perinatal deaths occurred against total 71 vaginal deliveries. Among 112 caesarean deliveries, 3(2.68%) stillbirths and 10(8.93%) neonatal deaths occurred respectively; that is why in total 13(11.61%) perinatal deaths occurred against total 112 caesarean deliveries. Besides these, perinatal deaths were counted as stillbirths which were 5 in number. In this study in total 56(29.79%) perinatal deaths occurred of total study people. Conclusion: In pregnant women with eclampsia frequency of caesarian delivery is near about two times than vaginal delivery. But the maternal mortality in caesarian delivery of pregnant women with eclampsia is near about half of that in vaginal delivery. In such cases, perinatal mortality is about one-fifth in caesarian delivery than that of vaginal delivery.
CASE REPORT | Feb. 27, 2021
Pseudoangiomatous Nodular Stromal Hyperplasia of the Breast (PASH): Case Report and Review of the Literature
Sounni A, Jayi S, Fdili A FZ, Chaara H, Melhouf MY A
Page no 41-43
Pseudoangiomatous nodular stromal hyperplasia of the breast (PASH) is a benign lesion characterized by the presence of anastomotic clefts lined with flattened cells giving a pseudo-vascular appearance , it is a rare pathological entity that manifests itself most often in perimenopausal patients. It poses a differential diagnostic problem with fibroadenoma, phyllodes tumor or hamartoma and it is the histology that confirms the diagnosis. We describe through a series of studies and also through our case the clinical, histological and therapeutic particularity of these tumors.
ORIGINAL RESEARCH ARTICLE | Feb. 28, 2021
A Critical Review of 100 Cases of Hysterectomy: A Prospective Study in a Tertiary Care Centre
Dr. Most Fatima Dolon, Dr. Rifat Sultana, Dr. Khadiza Rubab, Dr. Nabid Shahriar, Dr. Afrin Billah, Dr. Mahmuda Naher
Page no 44-48
Background: Hysterectomy is the removal of the uterus with or without cervix. When this is done through an abdominal incision it is called abdominal hysterectomy. When the approach is through vaginal vault it is called vaginal hysterectomy. Hysterectomy is a major gynecological operative procedure commonly indicated for women with dysfunctional bleeding, uterine leiomyoma, prolapse, endometriosis & adenomyosis, pelvic pain, premalignant conditions and cancer. Objective: The purpose of the study was to find out the common indications of hysterectomy. Methods: The Study was conducted in the department of obstetrics and gynaecology of Dhaka Medical College Hospital, Dhaka, Bangladesh to find out the common indications of hysterectomy. 100 cases were randomly selected for the study whose common indication of hysterectomy. Clinical examination and evaluation were done from October 2004 to February 2005. Other necessary investigations were done if clinically indicated and to prepare the patient for anesthesia. Statistical analysis of the results was obtained by using window-based computer software devised with Statistical Packages for Social Sciences (SPSS-22). Results: Majority of cases who underwent hysterectomy were 31-40 years (52%) of age. Out of 100 cases most of patients (70%) underwent abdominal hysterectomy and only 30 (30%) cases underwent vaginal hysterectomy. Out of 33 cases, clinically diagnosed as leiomyoma of the uterus histopathology revealed leiomyoma in 24 cases. In uncomplicated abdominal and vaginal hysterectomy, the duration of surgery was almost same, vaginal hysterectomies needs slightly longer time. Average hospital stay after operation was same. Conclusion: For a woman with severe pelvic pain or heavy irregular periods a hysterectomy often means relief from troublesome symptoms. Hysterectomy is offered as a definitive treatment and is associated with high level of satisfaction.