bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Utility of Biomarkers in Diagnosis and Management of High Grade Cervical Intraepithelial Neoplasia (HSIL)
Authors: Ferdous Jannatul , Khatun Sabera , Ashrafunnessa - , Chowdhury Shiuly , Begum Ferdousy , Akter Latifa , Khan Jawad Mahruj 
Published: June 2022

Objective of the study: The increasing inter- and intra-observer variability in the diagnosis of CIN by histopathology has led to the advent of different biomarkers. The aim of this study is to evaluate Ki-67 and p16 INK4a marker in differentiating CIN lesions and the clinical utility of it in the management of high grade squamous intraepithelial lesions (HSIL).
Materials and methods: This cross-sectional study has been carried out among the biopsy proved cases of CIN2 and CIN3 in which P16 and Ki-67 immunostain was performed in the Colposcopy clinic, Bangabandhu Sheikh Mujib Medical University (BSMMU) and Department of Pathology, BSMMU respectively from 14-3-17 to 30-05-18. Thirty-two cases were incorporated in the study by purposive sampling. Data was analyzed using SPSS version 17.
Results: Among 32 cases of HSIL, 25 were diagnosed as CIN 2 (78.13 %) and 7 cases as CIN 3 (21.87 %) by histopathology. All the cases were subjected to immunohistochemistry with P16 and Ki 67. Regarding the status of P16, it was found positive only in 32% cases of CIN 2 but in 100% cases of CIN 3. Similarly, Ki67 was found positive in 36 % of CIN2 cases but in all cases of CIN 3 lesions. Thus immunostain confirmed one third histopathologically diagnosed CIN 2 cases. On the other hand, all cases of CIN 3 were confirmed as HSIL with the immunostain. All the cases of CIN 2 were reviewed for consensus opinion. Only 8 (32%) cases of CIN 2 were both immunostain positive , the review diagnosis by consensus opinion was also CIN 2 in those cases. One case (4%) of CIN 2 was P16 negative but Ki 67 positive, which ultimately revealed as immature squamous metaplasia. Sixteen cases of CIN 2 were negative for both P16 and Ki 67. Among these, majority cases (52%) , consensus opinion revealed as CIN 1 and 12% cases as immature squamous metaplasia. Therefore, an HSIL diagnosed by histopathology could be false positive in a significant number of cases and overtreatment of a false positive CIN 2 lesion can affect future reproductive status, also have some psychological consequences and economic burden in the health sector.
Conclusion: By using the biomarkers, overtreatment and undertreatment of CIN can be avoided. All cases of CIN 2 should be carefully dealt with either review of the slides by consensus opinion or by doing immunohistochemistry if facility is available.
Bangladesh J Obstet Gynaecol, 2019; Vol. 34(2): 79-86
Association of Impaired Glucose Tolerance and Insulin Resistance in Women with Polycystic Ovary Syndrome
Authors: Begum Nasima , Yousuf Nusrat Ara , Farooq Md Shamim , Chowdhury Md Abul Kalam , Ferdous Menoka 
Published: June 2022

Objective: To find out association between impaired glucose tolerance and insulin resistance with Polycystic Ovary Syndrome (PCOS).
Materials and methods: This cross-sectional comparative study was carried out on women with polycystic ovary syndrome (PCOS) admitted in the department of Obstetrics and Gynaecology, SSMC Mitford Hospital and BSMMU Dhaka over a period of 2 years from July 2008 to June 2010.
Result: A total of 100 subjects, 50 cases and 50 controls were consecutively included in the study. The mean insulin resistance, impaired fasting glucose and impaired glucose 2 hours after 75 gm of glucose were observed to be significantly higher in cases than in controls (26.7+8.4 vs. 18.8+7.5 micro IU /ml, p<0.001) The prevalence of insulin resistance ,impaired fasting serum glucose and impaired glucose 2 hours after 75 gm of glucose also higher among study group compared to control group (70% vs. 12%;44% vs. 10% and 56% vs. 10 % respectively ).
Conclusion: Impaired glucose tolerance and insulin resistance are useful parameter for diagnosis of PCOS.
Bangladesh J Obstet Gynaecol, 2019; Vol. 34(2): 93-98
Increasing trends in Deep Infiltrating Endometriosis (DIE) with Bilateral Endometrioma from Adolescence till Menopause: Case Series
Authors: Bhatia Ruby , Kaur Naazbir , Mor Sunita , Jain Shivangi 
Published: June 2022

Deep infiltrating endometriosis has varying clinical presentaions with certain diagnostic signs and symptoms. Bilateral endometriomas alongwith DIE has been observed in all the age groups in this series at more than 35 years of age.
Bangladesh J Obstet Gynaecol, 2019; Vol. 34(2): 127-133
Outcome of Septic Abortion –Experience from a Tertiary Referral Hospital
Authors: Alam Irin Parveen , Paul Shroddha Nibedita , Akhter Parul 
Published: June 2022

Objective: Septic abortion is a life threatening complication of induced abortion. Being a tertiary referral hospital in Bangladesh, Sir Salimullah Medical College and Mitford Hospital often deals with such cases of septic abortion. This research work was conducted with the aim of evaluation of frequency, complications and outcome of septic abortion in this institute.
Method: A cross sectional observational study was conducted from January 2016 to December 2016 in the department of Obstetrics and Gynaecology, Sir Salimullah Medical College and Mitford Hospital, Bangladesh. All cases of septic abortion admitted in the department were included in the study.
Results: During one-year period total number of Gynaecological admission cases were 11,351, of which 1065 were abortion cases, among them 28 cases were diagnosed as septic abortion. The frequency of septic abortion thus was 2.6% of the abortion admitted cases. Age range of the patients was between 15 to 45years. Majority (60.71%) of the cases were grand multigravida, belonging to poor socioeconomic group (71%). Most of the patients (68%) came with haemorrhage. The most frequent method (50%) used for termination of pregnancy in this study was Menstrual Regulation (MR) in unhygienic environment. Mostly (57.14%) the patients were managed by evacuation and curettage. Laparotomy was also needed for the definitive management of two patients. Maternal mortality in this study group was one out of 28(3.7%).
Conclusion: Septic abortion contributes significantly to maternal morbidity and mortality. Proper use of contraceptives, avoidance of induced abortion in unhygienic condition can reduce the moribund consequences. In this study one maternal death among 28 septic abortion cases indicate proper standard of care of the hospital.
Bangladesh J Obstet Gynaecol, 2020; Vol. 35(1): 3-6
Menstrual Phenotypes in Relation to Insulin Resistance in Infertile Women with Polycystic Ovary Syndrome
Authors: Ishrat Shakeela , Hossain Marufa 
Published: June 2022

Objective: To explore the menstrual phenotypes associated with endocrine, metabolic characteristics of infertile women with polycystic ovary syndrome.
Materials and methods : The cross sectional study was carried out among 125 infertile women with polycystic ovary syndrome attending Infertility wing of the Department of Obstetrics & Gynaecology, Bangabandhu Sheikh Mujib Medical University, Dhaka from January 2017 to December 2017. The women were evaluated by clinical history, examination, transvaginal sonogram and for endocrine and metabolic parameters. The women were divided into 5 groups according to their menstrual phenotypes: i) cycle length 21-35 days ii) oligomenorrhoea or cycle length > 35 days but less than 6 months iii) secondary amenorrhoea or cycle length ³6 months iv) polymenorrhoea or cycle length <21 days v) oligomenorrhoea alternating with polymenorrhea. One way ANOVA was used for analyzing the variance between groups. Categorical variables were analyzed for association by Fishers Exact Test and Chi Square tests where appropriate.
Results: A total of 125 women were recruited for the study. The women were divided into 5 groups according to their menstrual phenotype: i) cycle length 21-35 days (n=5) ii) oligomenorrhoea or cycle length > 35 days but less than 6 months (n=70) iii) secondary amenorrhoea or cycle length ³6 months (n=35) iv) polymenorrhoea or cycle length <21 days (n=2) v) oligomenorrhoea alternating with polymenorrhea (n=13). Accordingly the women with oligomenorroea with or without polymenorroea was most frequent (65%) followed by women with secondary amenorrhea (27%), regular cycle (0.04%) and isolated polymenorroea (0.01%). One way ANOVA revealed significant difference between groups in fasting insulin and serum testosterone level. There is significant association of oligomenorroea (with or without polymenorrhoea) with insulin resistance (HOMA-IR ³2). There is significant association of secondary amenorrhoea with hyperinsulinaemia ( Fasting insulin ³10mIU/L) and insulin resistance (HOMA-IR ³2).
Conclusions: Menstrual history of infertile women with polycystic ovary syndrome can be a clinical marker of insulin resistance and related metabolic risk.
Bangladesh J Obstet Gynaecol, 2020; Vol. 35(1): 32-36
Fertility-sparing Surgery (FSS) in Epithelial Ovarian Cancer (EOC): A Case Report
Authors: Khatun Shahla , Deeba Farzana , Alam ABM Muksudul , Ivy Roksana , Parveen Farhana 
Published: June 2022

Background: Epithelial ovarian cancer is the most common and lethal ovarian cancer. Now a days Fertility preservation is an important issue because of the constant shifting of childbearing age towards higher ages. The increasing incidence of epithelial ovarian cancer in women with active childbearing potential constitutes a therapeutic dilemma. Fertility sparing techniques are being increasingly incorporated in the therapeutic strategies in early stages of the disease. Established organ-preserving techniques in early stage epithelial ovarian cancer includes preservation of the contralateral ovary and uterus.
Aim: To report the case of a Epithelial Ovarian Cancer, who had conservative surgery followed by chemotherapy with a good fertility outcome.
Case presentation: A 31-year-old nulliparous woman with a right sided ovarian mucinous cystadenocarcinoma was treated by right adnexectomy and omentectomy followed by chemotherapy. A 3years follow-up showed no signs of relapse, and she completed a fullterm natural pregnancy which was delivered by caesarean section.
Conclusion: Fertility sparing surgery in early stage Epithelial Ovarian Cancer has good prognosis. However, due to the rarity of the disease in early stages, the fertility outcome of this group of patients has not been established.
Bangladesh J Obstet Gynaecol, 2020; Vol. 35(1): 46-48
Anti-diabetic activity of Iphiona aucheri leaf extract
Authors: Shah Muhammad Abdur Rehman , Khan Rahmat Ali , Ahmed Mushtaq 
Published: June 2022

The methanolic extract of Iphiona aucheri leaves and its n-hexane, chloroform and aqueous fractions were screened for phytochemicals, cytotoxic effects, total phenolic contents, antioxidant and anti-diabetic properties. The methanolic extract was assessed for its in vivo anti-diabetic effects. The results indicated the presence of alkaloid, protein and amino acids, carbohydrates, glycosides, flavonoids, and saponins along with the highest brine shrimp lethality (90.7 ± 1.8%), α-amylase inhibition (60.2%) and free radical scavenging properties. The diabetic control indicated a significant (p<0.05) decrease in weight and high-density lipoprotein and elevated level of blood glucose, bilirubin, creatinine, urea, triglyceride, low density lipoprotein, very low-density lipoprotein, transaminases, and alkaline phosphatase. All these changes were restored significantly (p<0.05) by treatment of diabetic rats with methanolic extract of I. aucheri. The results show the potential of I. aucheri as a source of therapeutic compounds against diabetic, hyperlipidemia and free radical associated disorders.
Post Traumatic Stress Disorder among the Forcibly Displaced Rohingya Population from Myanmar Nationals in Bangladesh
Authors: Alam Md Fayshal , Jahan Syeda Saberin , Amin Mohammad Nurul , Tasmin Sinthia , Halim Kazi Shafiqul , Nurunnabi Mohammad 
Published: June 2022

Forcibly Displaced Myanmar Nationals (FDMN's) specially Rohingya population considered as a maltreated minority. They suffered physical brutality that consequences are physical, sexual and psychological trauma. This community based cross-sectional study was carried out to ascertain the prevalence rate and associated factors of post traumatic stress disorder (PTSD) among the 363 adult Rohingyas in the Kutupalong and Nayapara refugee camps, Cox’s Bazar, Bangladesh by a semi-structured questionnaire through face-to-face interviews during the study period of June 2018 to November 2018. Among the 363 study participants, 60.33% had probable PTSD. The prevalence of PTSD was found higher in female (64.7%) in comparison to male (53.52%) and a statistically significant association (P=0.03) found between sex and PTSD. Married people had a higher prevalence of PTSD (64.62%) in compared to unmarried people and a significant association (P=0.003) found with the presence of PTSD. The prevalence of PTSD was very high (72.55%) among the respondents those faced sexual exploitation. Among the exploitations related variables, having previous experience of sexual exploitations were found statistically significant associated (P=0.039) with PTSD. Hypertension had a statistically significant association (P=0.02) with PTSD and the prevalence of PTSD among Hypertensive patients was 71.79%. Probable PTSD was highly prevalent among the Rohingya population in Bangladesh. Measures should be taken by trained healthcare professionals and mental healthcare providers.
Bangladesh Med J. 2021 January; 50(1) : 39-45
Management of idiopathic granulomatous mastitis: dilema in diagnosis and management
Authors: Akhter Nasima , Lqbal Abu Khaled Mohammad , Rahman Md Mahbubur , Gupta Joydeep Datta , Alam ABM Khurshid 
Published: June 2022

Background: Idiopathic granulomatous mastitis is a rare disease of the breast. Clinically and radiologically it may mimic breast carcinoma. To date, there is no agreed gold standard treatment for IGM. The clinical management often starts with tests to eliminate microbial infection and when microbial infection can be ruled out, long-term oral steroid treatment or surgery is administered.
Objective: To see the response of different treatment options of idiopathic granulomatous mastitis.
Methods: This is a retrospective study involved 50 patients who were diagnosed with IGM and were treated in our institution between January 2009 to December 2016.
Results: The mean age of patients was 34.3 years. Breast lump was the most common presentation. The right breast was affected in 30 cases & left breast 20 cases. 4 patients were pregnant at the time of presentation. Lactation within 6 months of presentation was documented in 4patients.45 patients used contraceptives pills. A clinical suspicion of malignancy was present in 17 cases. Mammography was performed in 20 patients and showed focal asymmetrical dense lesions in 9, well-circumscribed opacity in 8, speculated lesion in 1, and was normal in 2. Fine-needle aspiration was performed in 40 patients. Wide local excision was the mainstay of treatment. One patient underwent mastectomy due to recurrence and the final histology confirmed idiopathic granulomatous mastitis with no evidence of malignancy. 12 patients developed recurrence after a mean follow-up of 31.2 months.
Conclusion: IGM is not so rare disease in our country. Clinical, radiologic, and even cytological findings are sometimes confused with malignancy. Adequate Surgical treatment as well as adjuvant therapeutic treatment are necessary. Knowledge, awareness and co-operation among surgeons and pathologist should also be strengthen to avoid unnecessary misdiagnosis and treatment.
Journal of Surgical Sciences (2017) Vol. 21 (2): 89-93
Role of alvarado score in diagnosis of acute appendicitis
Authors: Md Fardhus - , Sharfuzzaman AMSM , Dewan Md Nayeem , Rab Joy Zakharia 
Published: June 2022

Background: Appendicitis may be associated with morbidity and occasionally mortality. If failed to diagnose early, the situation may become more complicated.
Objective: To validate the role of Alvarado score in diagnosis of acute appendicitis.
Methods: A total of 282 patients with clinically diagnosed acute appendicitis were included in this study. Patients were examined thoroughly, investigated and managed accordingly. The relevant data collected and analyzed. Results: Out of 282 patients, surgical procedures were performed in 59.57% of the patients. The overall negative Appendectomy rate was 9.52%, and the percentage of Positive Predictive Value (PPV) for Alvarado score was 92.26%.
Conclusion: Our study validates the Alvarado score as fast, simple and reliable diagnostic tool for acute appendicitis.
Journal of Surgical Sciences (2017) Vol. 21 (2): 94-98
Comparison of outcome between traditional open haemorrhoidectomy and stapled haemorrhoidectomy operation
Authors: Shumi Farjana Haque , Ali Md Omar , Hossain Md Akram 
Published: June 2022

Background: Haemorrhoidectomy is a surgical excision and removal of the hemorrhoid used primarily only in severe cases. There are many different types of haemorrhoidectomy like open haemorrhoidectomy and stapled haemorrhoidectomy.
Objective: To compare the outcome of stapled haemorrhoidectomy and traditional open haemorrhoidectomy. Methods: This is a cross sectional study of 72 cases who underwent open and stapled haemorrhoidectomy operation for symptomatic 2nd, 3rd and 4th degree hemorrhoids. Binomial probability pre-posttest were used for statistical analysis, p value less than 0.05 was taken as significant.
Results: : Among 72 patients, 34 patients of conventional haemorrhoidectomy and 38 of stapled haemorrhoidectomy at 3 months post-surgery in conventional group 1 patient was unsatisfied, 12 patients were satisfied and 4 patients stated their condition good. In stapled group 14 patients stated their condition excellent and 5 patients stated their condition good. Statistical analysis shows that level of satisfaction at 3 months post-surgery in conventional group and stapled group was statistically significant(p-value<.001).
Conclusion: Stapled haemorrhoidectomy is a relatively new procedure. Stapled haemorrhoidectomy is a safe procedure, less pain and disabled than the conventional haemorrhoidectomy.
Journal of Surgical Sciences (2017) Vol. 21 (2): 99-104
Percuteneous Trans-Mitral Commissurotomy (PTMC); Procedural Success and Immediate Results, an Experience from Tertiary Care Hospital in Northern Division of Bangladesh
Authors: Rahman Mahbubur , Ghafur Shakil , Barman Rabindra Nath , Sarkar Haripada , Basunia Abu Zahid , Islam Md Hasanul , Mahmud Abdullah Al 
Published: June 2022

Background: One of the ultimate grave consequences of rheumatic heart disease is mitral stenosis. Percutaneous trans-mitral commissurotomy (PTMC) has been practiced with good results in the world since Inoue introduced it in 1982.
Objective: The aim of this study was to audit the procedural success, in- hospital outcome in patients undergoing PTMC in our set up. Study Design: Observational cross sectional study. Place and Duration: The study was conducted in northern division of Bangladesh with the collaboration of department of cardiology, Rangpur Medical College Hospital, Rangpur & Zia Heart Foundation, Dinazpur from February 2018 to November 2019.
Materials and Methods: Total Thirty patients who fulfill the inclusion and exclusion criteria for PTMC was enrolled in this study. Among them the procedural success & immediate results were assessed.
Results: Among 30 patients , 22(73.33%) were female and 8(26.66%) were male showing a female predominance. The mean age was 28.28±8.4.The procedure was successful in 29(96.66%) patients. In 1(3.3%) patient, we failed due to inability to puncture the septum for unfavourable anatomy. There was no mortality related to the procedure, no systemic embolization but one patient (3.33%) had significant MR(G II ). Pre PTMC mean MVA (cm2) was 0.801± 0.1325 and post PTMC it was 1.545± 0.292 cm2. Mean MVPG pre PTMC was 27.108±5.94 mmHg and post PTMC , 6.61±5.008 mmHg with significant p value 0.0001. Mean LA pressure before procedure was 28.65±8.456 mmHg and post PTMC, 11.27±6.34 and p value was 0.0001. Most of the patients 25(83.3%) before PTMC were in severe pulmonary hypertension and after PTMC most of the patients 21(70%) were in mild pulmonary hypertension.We successfully done 7 special cases like pregnancy, re do cases, H/O CVD etc.
Conclusions: We conclude that PTMC is a safe procedure in experienced hand with good success rate and optimal results even in patients with special problems like pregnancy, previous CVA and redo cases.
University Heart Journal Vol. 17, No. 1, Jan 2021; 47-54
Peripartum Cardiomyopathy: A Case Series
Authors: Salim Md Abu , Rahman Mohammad Walidur , Adhikary Dipal Krishna , Arzu Jahanara , Hoque Md Harisul , Joarder Ariful Islam , Mahmood Manzoor 
Published: June 2022

Peripartum cardiomyopathy (PPCM) is a life threatening entity of peripartum period characterized by left ventricular systolic dysfunction and heart failure in absence of any known cardiac disease. Though its incidence is rising but there is still uncertainty regarding its incidence, pathogenesis, and optimum management protocol. Retrospective analysis of twenty cases of PPCM admitted, within July 20016 to June 2018 in the department of Cardiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka is done here. Mean age of study population was 25 (6.3). Majority of the patients were multi-paras 12 (60%). 80% of the patients were diagnosed after delivery. Breathlessness was the most common symptom. Bibasal lung base crepitations was most frequent sign, which was found in 95% cases. Sinus tachycardia was most frequent electrocardiographic change which was found in 80% cases. Mean left ventricular ejection fraction (LVEF) was 35.2(2.8). All the patients had different extent of global hypokinesia of left ventricle (LV) at rest. The patients were treated with bed rest, water and salt restriction, loop diuretic, digitalis, selective Beta-blocker, vitamin B complex and an anticoagulant in relevant cases in antepartum period, Angiotensin converting enzyme inhibitor (ACEI) or Angiotensin receptor blocker (ARB) was added in postpartum period.70% patients were clinically improved and in 45% the left ventricular functional status returned to normal. 30% developed persistent cardiomyopathy beyond six months of presentation. Maternal mortality was 1 (5%). Among all live births three had intra uterine growth retardation. The pathophysiology, emerging investigations modalities, updated management protocol, and prognosis of PPCM are also discussed in this review.
University Heart Journal Vol. 17, No. 1, Jan 2021; 71-75