Background: Diagnostic delay is an important barrier to timely management of gynaecological malignancies and may result from patient-, provider-, and health-system-related factors. Identifying referral patterns and stages of delay may help improve timely diagnosis. Objective: To assess the patterns of referral and diagnostic delay among women with newly diagnosed gynaecological malignancies attending a tertiary care hospital. Methods: This prospective observational study was conducted from January 2026 to June 2026 among 150 women with newly diagnosed, histopathologically confirmed gynaecological malignancies attending the Department of Gynaecological Oncology, National Institute of Cancer Research & Hospital, Dhaka. Sociodemographic characteristics, presenting symptoms, initial healthcare contact, referral source, number of healthcare visits, diagnostic investigations, and reasons for delay were recorded. Diagnostic intervals were assessed from symptom onset to first healthcare contact, referral, specialist consultation, and histopathological confirmation. Results: The mean age of participants was 48.5 ± 13.8 years. Cervical cancer was the most common malignancy (52.0%), followed by ovarian (21.3%) and endometrial cancer (16.0%). Private clinics/hospitals were the most common initial healthcare facility (32.0%), while government hospitals were the leading referral source (31.3%). The mean overall diagnostic interval was 95.6 ± 48.3 days, and 39.3% of participants had an interval exceeding 90 days. Lack of awareness (36.0%), financial constraints (31.3%), delayed referral (27.3%), and repeated consultations (25.3%) were the major reported contributors to delay. Conclusion: A considerable diagnostic interval was observed, with delays occurring at multiple stages of the healthcare pathway. Strengthening awareness, referral systems, and timely diagnostic services may facilitate earlier diagnosis.

Background: Caesarean section rates continue to rise worldwide, and emergency caesarean delivery is typically undertaken to avert serious maternal or fetal complications. The spectrum of indications leading to emergency caesarean section varies across countries and institutions, and local data from Bangladeshi tertiary hospitals remain limited. This study aimed to determine the common indications for emergency caesarean section among women managed at Kurmitola General Hospital, Dhaka. Methods: This cross-sectional observational study was conducted in the Department of Obstetrics and Gynaecology, Kurmitola General Hospital, from July 2019 to December 2019. One hundred women with a singleton pregnancy beyond 28 weeks who underwent emergency caesarean section were enrolled by purposive sampling. Data were collected using a pre-tested, observation-based questionnaire and analysed using SPSS version 23. Results: The highest proportion of mothers (62%) were aged 21-25 years, with a mean age of 24.63±5.31 years. Forty-three percent were primigravida, and 54% had a gestational age of 37 weeks or more. Among fetal indications, fetal distress was the leading cause (22%), followed by severe intrauterine growth restriction (5%) and cord prolapse (1%). Among maternal indications, obstructed labour or failure to progress accounted for 21% of cases, malpresentation and pregnancy-induced hypertension each accounted for 13%, antepartum haemorrhage for 11%, previous caesarean section with scar tenderness for 9%, failed induction for 7%, and primary dysfunctional labour and cephalopelvic disproportion each for 4%. Conclusion: Fetal distress was the single most important indication for emergency caesarean section, while obstructed labour, pregnancy-induced hypertension and antepartum haemorrhage represented the principal maternal indications at this tertiary care center.

Nickel-based electrocatalysts have emerged as important alternatives to precious metal catalysts for alkaline water electrolysis because of their abundance, relatively low cost, electrical conductivity, and compatibility with alkaline operating environments. Considerable progress has been achieved through alloying, phase engineering, nanostructuring, defect generation, heterointerface construction, and electrode–substrate integration, particularly in Ni–Co, Ni–Mo, nickel sulfide, nickel phosphide, nickel oxide, and nickel hydroxide. However, reported improvements in electrocatalytic activity do not necessarily translate into efficient and durable hydrogen production under practical operating conditions. This review critically examines the relationship between Ni-based catalyst composition, structure, electrochemical reconstruction, catalytic activity, and long-term stability in alkaline water electrolysis. Attention is given to the dynamic transformation of Ni-containing surfaces during operation, the influence of Fe, Co, and Mo incorporation, structural and interfacial engineering, and the effects of catalyst architecture on mass transport and gas-bubble management. This critical review further evaluates the limitations of conventional low-current-density catalyst screening. It emphasizes high-current-density performance, full-cell voltage, Faradaic efficiency, electrode integrity, and long-term durability as more meaningful indicators of practical performance. Finally, it discusses the challenges associated with operating-state characterization, standardized testing, dynamic operation, scalable electrode fabrication, and translation from laboratory electrodes to practical electrolyzers. By connecting catalyst design with electrode engineering and electrolyzer-level performance, this review provides a framework for developing Ni-based electrodes capable of combining high activity, structural stability, and sustained hydrogen production under industrially relevant alkaline electrolysis conditions.

Background: Maternal hyperglycaemia is the central pathophysiological driver of adverse perinatal outcome in gestational diabetes mellitus (GDM), yet the comparative magnitude of risk between well-controlled and poorly controlled disease remains under-documented in South Asian tertiary-care settings. This study aimed to evaluate the association between the level of glycaemic control and perinatal outcome among women with GDM. Methods: This cross-sectional observational study included 100 women with GDM managed at a tertiary hospital in Dhaka between March and August 2017. Patients were classified as well-controlled (HbA1c <6.5, n=58) or poorly controlled (HbA1c ≥6.5, n=42) and perinatal outcomes were compared between the two groups using the chi-square test in SPSS version 20, with p<0.05 considered significant. Results: Low birth weight (<2.5 kg) and macrosomia (>4.0 kg) were each roughly twice as frequent among poorly controlled mothers (66.67%) as among well-controlled mothers (33.33%), whereas birth weight in the 3.1–3.5 kg range predominated in the well-controlled group (72.00% versus 28.00%). Postnatal maternal complications, including postpartum haemorrhage, wound infection and urinary tract infection, were markedly concentrated among poorly controlled patients (p=0.001). Neonatal morbidity, encompassing hypoglycaemia, hyperbilirubinaemia, respiratory distress syndrome, birth asphyxia and prematurity, was substantially higher among poorly controlled cases (p=0.001) and all six perinatal deaths recorded in the cohort (6%) occurred exclusively among poorly controlled patients. Conclusion: Glycaemic control status was strongly and significantly associated with neonatal morbidity, postnatal maternal complications and perinatal mortality in GDM, confirming strict glycaemic control as the principal modifiable determinant of favourable perinatal outcome.

Background: Adenomyosis is an estrogen-dependent uterine disorder commonly associated with heavy menstrual bleeding, dysmenorrhea, uterine enlargement and anemia. In perimenopausal women, hormonal treatment is often preferred to preserve the uterus and avoid surgery. However, real-world evidence on treatment outcomes in this age group remains limited, particularly in Bangladeshi clinical settings. This study evaluated clinical outcomes, satisfaction and tolerability of hormonal therapy. Methods: This retrospective observational study was conducted at the Department of Obstetrics and Gynaecology, Mugda Medical College & Hospital, from June 2023 to July 2024. A total of 150 women aged 40–52 years with ultrasonography-confirmed adenomyosis received LNG-IUS, dienogest, or GnRH agonists and had a six-month follow-up. Clinical, hematological, satisfaction and adverse-effect data were extracted from records. McNemar’s test was used for paired outcomes, with p<0.05 considered significant. Results: At six months, menorrhagia decreased from 92.0% to 4.0%, severe pelvic pain/dysmenorrhea from 78.7% to 12.0%, uteromegaly from 49.3% to 14.7% and anaemia from 69.3% to 17.3% (all p<0.001). Amenorrhea was achieved by 58.7% of participants, while 86.7% were satisfied or highly satisfied with treatment. Irregular spotting/breakthrough bleeding was the most frequent adverse effect (29.3%), followed by weight gain (17.3%). Overall, adverse effects were manageable. Conclusion: Hormonal therapy was associated with six-month improvement in bleeding, pain, uterine enlargement and anemia, with high treatment satisfaction and tolerable adverse effects. These findings support hormonal therapy as a uterus-conserving option for symptomatic adenomyosis in perimenopausal women.

Background: Preeclampsia remains a leading cause of severe maternal morbidity worldwide and its early- and late-onset phenotypes are increasingly recognised as differing in severity and complication profile. This study aimed to compare the pattern of severe maternal morbidity between women with early-onset preeclampsia (EOP) and late-onset preeclampsia (LOP) and to contrast these outcomes with normotensive pregnancies. Methods: A hospital-based case control study was conducted in the Department of Obstetrics and Gynaecology, BIRDEM General Hospital, Dhaka, over six months (March to August 2019). One hundred women with preeclampsia (50 EOP and 50 LOP) and 50 normotensive controls were enrolled consecutively. Structured interview, clinical examination and review of laboratory records were used to document severe maternal complications, including HELLP syndrome, acute kidney injury (AKI) and disseminated intravascular coagulation (DIC). Data were analysed using SPSS, with the chi-square or Fisher exact test applied as appropriate and p<0.05 considered significant. Results: Baseline maternal age, height and weight were comparable between EOP and LOP groups (p>0.05). DIC occurred in 5 (10.0%) women with LOP versus none with EOP (p=0.056) and AKI occurred in 1 (2.0%) LOP case versus none in EOP. No maternal deaths occurred. Compared with controls, HELLP syndrome (10.0% vs 0%, p=0.016) and AKI (8.0% vs 0%, p=0.034) were significantly more frequent among women with EOP, while DIC was significantly more frequent among women with LOP than controls (10.0% vs 0%, p=0.022). Conclusion: Severe maternal morbidity differs qualitatively between early- and late-onset preeclampsia, with EOP more strongly associated with HELLP syndrome and acute kidney injury and LOP more strongly associated with disseminated intravascular coagulation, when each phenotype is compared with normotensive pregnancy.

Uterotibb is a traditional Unani polyherbal formulation used in women’s healthcare. Despite its longstanding traditional use, systematic evidence regarding its phytochemical composition and biological activities remains limited. The current study aimed to characterize the phytochemical constituents of Uterotibb and evaluate the antioxidant and antimicrobial activities of its aqueous and ethanolic extracts to provide scientific support for its traditional use. Aqueous and ethanolic extracts were subjected to gas chromatography–mass spectrometry (GC–MS) for phytochemical profiling. Antioxidant activity was evaluated using DPPH and ABTS radical-scavenging assays, while antimicrobial activity was assessed against selected Gram-positive and Gram-negative bacterial strains. IC₅₀ values and minimum inhibitory concentrations (MICs) were determined. GC–MS identified phenolic derivatives, lipophilic phenolics, fatty acid esters including hexadecanoic acid, terpenoids, aromatic compounds, quinone-related structures, and phytosterols. The ethanolic extract showed 95.7 ± 0.91% scavenging potential at 1.1 mg/mL concentration, where IC₅₀ values of 0.68 mg/mL for DPPH and 1.07 mg/mL for ABTS. The aqueous extract showed 86.86 ± 0.30% scavenging at 1.1 mg/mL concentration, with IC₅₀ values of 0.821 and 1.133 mg/mL for DPPH and ABTS respectively. Both extracts exhibited an MIC of 1 mg/mL against all tested Microorganisms. The ethanolic extract lowest IC₅₀ values against Gram-positive and Gram-negative bacteria were 0.38 and 0.52 mg/mL, respectively, compared with1.62 and 2.15mg/mL for the aqueous extract against tested bacterial strains. The findings support the traditional use of Uterotibb and highlight its potential as a source of bioactive phytochemicals warranting further pharmacological investigation.