Introduction: Both maternal nutritional status and GDM have impact on pregnancy outcome. But, data from Bangladesh in this issue is still scarce. To design and utilize national obstetric health care, ...nutritional status of GDM women and its impact in the birth weight of babies should be evaluated and therefore, this study was designed.
Methods: This prospective cohort study was conducted in the department of Obstetrics and Gynecology at BIRDEM General Hospital-2, Dhaka to evaluate the nutritional status of GDM women and its impact on pregnancy outcomes.
Results: The mean age of the patients in the study was 29.71± 5.06 years. The mean age, Mid Upper Arm Circumference (MUAC,) and Body Mass Index (BMI) were significantly higher in GDM mothers (p <0.05). Additionally, gestational weight gain between 28 weeks and before delivery was significantly higher in GDM mothers (p <0.001). The mean birth weight of the newborns was also higher in the GDM group (3.23±0.46vs. 2.97±0.37 kg) (p <0.05). Macrosomic neonates were observed only in the GDM group (4.36%). APGAR score was significantly better in non-GDM mothers’ babies (p <0.05). Babies of GDM mothers had a significantly higher proportion of birth asphyxia, septicemia, pneumonia, Intrauterine Growth Retardation (IUGR), and Neonatal Intensive Care Unit (NICU) admissions (p <0.05). Macrosomic mothers had significantly higher BMI and higher gestational weight gain (p<0.05).
Conclusion: Mothers with GDM had a higher rate of bad pregnancy outcomes and that macrosomia was linked to a higher BMI.
J Bangladesh Coll Phys Surg 2023; 41: 63-74
E. coli is one of the major significant pathogens causing mastitis, the most complex and costly diseases in the dairy industry worldwide. Present study was undertaken to isolate, detect the virulence ...factors, phylogroup, antimicrobial susceptibility and antimicrobial resistance genes in E. coli from cows with clinical mastitis. A total of 68 milk samples comprising 53 from clinical mastitis and 15 from apparently healthy cattle were collected from four different established dairy farms in Bangladesh. E. coli was isolated from the milk samples and identified by PCR targeting malB gene and sequencing of 16S rRNA gene. E. coli isolates were screened by PCR for the detection of major virulence genes (stx, eae and cdt) of diarrheagenic E. coli followed by phylogenetic grouping. Antimicrobial susceptibility of the E. coli isolates was determined by disk diffusion test and E. coli showing resistance was further screened for the presence of antimicrobial resistance genes. E. coli was isolated from 35.8% of the mastitis milk samples but none from the apparently healthy cattle milk. All the E. coli isolates were negative for stx, eae and cdt genes and belonged to the phylogenetic groups A and B1 which comprising of commensal E. coli. Antibiotic sensitivity testing revealed 84.2% (16/19) of the isolates as multidrug resistant. Highest resistance was observed against amoxicillin (94.5%) followed by ampicillin (89.5%) and tetracycline (89.5%). E. coli were found resistant against all the classes of antimicrobials used at the farm level. Tetracycline resistance gene (tetA) was detected in 100% of the tetracycline resistant E. coli and blaTEM-1 was present in 38.9% of the E. coli isolates. Findings of this study indicate a potential threat of developing antimicrobial resistance in commensal E. coli and their association with clinical mastitis. Occurrence of multidrug resistant E. coli might be responsible for the failure of antibiotic therapies in clinical mastitis as well as pose potential threat of transmitting and development of antibiotic resistance in human.
In an unfavourable environment, best management practices can greatly reduce the yield gap of many crops; however, the performance of best management practices on sunflower yield and economics in ...salt-affected low-intensive cropping areas of Bangladesh has yet to be determined. Sunflower (Helianthus annuus L.) cultivation in the coastal areas of Bangladesh faces significant challenges, such as increasing soil salinity in the sowing period, lack of sweet water for irrigation, an insufficient supply of quality seeds of high-yielding varieties, and inadequate farmers' knowledge of best production practices. Therefore, the study aimed to evaluate management approaches and varieties to enhance the productivity of sunflowers in salt-affected regions. The study was conducted in two consecutive Rabi seasons (2014-2015 and 2015-2016) in Benarpota, Satkhira, Bangladesh. The trial included two popular sunflower varieties (BARI sunflower 2, and SVS 00901) and three management practices (poor, moderate, and best management). Poor and moderate management practices were identified based on the farmers' survey in this area. The best management practices ware decided based on the BARI recommended practices. In both years, the seed yield of BARI sunflower 2 had 10- 15% higher than the seed yield of the variety SVS 00901. The best management practices had 25-30% and 35-42% higher seed yields of sunflower than the moderate and poor management, respectively. The best management practices had always higher gross returns, and across varieties, it was 25-30% and 35-40% higher than the moderate and poor management practices resulting in 30-32% and 30-36% higher net return, respectively. Best management practices greatly reduced the salinity level of soil during the cropping period, hence, the salinity stress was comparatively lower than the poor and moderate management. Best management practices with quality sunflower varieties can boost the productivity and profitability of sunflower in coastal Bangladesh and can increase households' income by increasing the cropping intensity.
Acute promyelocytic leukemia (APL) is one of the most curable subtypes of acute myeloid leukemia in childhood. It usually presents with a characteristic coagulopathy. The aim of the study was to ...determine the extent and outcome of this coagulation disorder.
This prospective observational study was conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, and included PML:RAR-α (Promyelocytic Leukemia-Retinoic Acid Receptor-α) positive APL cases. At presentation, all patients were assessed with coagulation parameters and followed up clinically and hematologically while treated with ATRA (all-trans-retinoic acid)-based chemotherapy. The presence of disseminated intravascular coagulation (DIC) was determined using the DIC scoring system of the International Society on Thrombosis and Hemostasis (ISTH).
Among 20 APL cases, the mean DIC score was 5.75 ± 0.6. DIC was detected in 90% (n = 18/20) of the patients. The incidence of fatal thrombo-hemorrhagic complications was 15% (n = 3/20). Though hemorrhagic complications are common, thrombosis may also occur in pediatric APL.
Objective: To document the clinical, biochemical and imaging phenotypes of immunocompetent patients with adrenal histoplasmosis. Methods: The clinical, biochemical and radiologic data of 18 ...immunocompetent patients age: 45.00 (39.25, 56.25) years, median (IQR), m/f (16/2) with adrenal histoplasmosis presenting in the Department of Endocrinology, BSMMU between 2014 and 2020 were retrospectively analyzed. Results: All patients were seronegative for HIV infection, and 27.8% (5/18) had well controlled diabetes mellitus. The median duration of the symptoms was 6.00 (IQR: 4.00, 11.25) months. All had significant weight loss, anorexia and weakness. Fever was present in 61.1% (11/18) patients and night sweat was present in 27.8% (5/18) cases. Hypotension and hyperpigmentation were present in 55.6% (10/18) and 66.7% (12/18) cases, respectively. Three of 18 patients presented with adrenal crisis. Hyponatremia occurred in 55.6% (10/18) cases, but none had hyperkalemia. Thirteen of 18 patients had adrenal insufficiency whereas 83.3% (15/18) had high adrenocorticotropic hormone. CT scan revealed bilateral adrenal enlargement in all cases with oval shape and regular margin. All were hypodense having radiodensity 21-90 hounsfield unit, and 11.1% (2/18) were heterogeneous in contrast enhancement. None had noticeable calcification whereas 1.1% (2/18) cases had central necrosis with peripheral rim enhancement. Hepatomegaly was present in 6 cases, splenomegaly in 3 cases and 5 patients had abdominal lymphadenopathy. Histoplasmosis were confirmed by positive fine needle aspiration cytology of adrenal tissue. Conclusions: Adrenal histoplasmosis should be considered in the list of differentials of bilateral adrenomegaly in immunocompetent individuals even living in non-endemic areas.
Purification and characterization of intracellular cellulase produced by A. oryzae ITCC-4857.01 are reported. The enzyme was purified by ion-exchange chromatography using DEAE-cellulose followed by ...Gel filtration. The purification achieved was 41 fold from the crude extract with yield of 27%. The purified enzyme showed single band on poly acrylamide gel. The molecular weight as determined by SDS-PAGE and gel filtration was 38 KDa and 38.6 KDa respectively and contained only one subunit. The enzyme is glycoprotien as nature and contained 0.67% neutral sugar. The apparent Km value of the enzyme against cellulose was 0.83%. The enzyme showed the highest relative ativities on CMC followed by avicel, salicin and filter paper. The optimum pH of activity was 5.5 and very slight activity was observed at or above pH 7.5 as well as bellow pH 3.5. The optimum tempreture of the activity was $45^{\circ}C$ and the highest activity was exhibited in 35 to $45^{\circ}C$. The enzyme lost their activities almost completely (95${\sim}$100%) at $80^{\circ}C$ or above and as well as bellow $25^{\circ}C$.
Background: Benign cystic teratoma or dermoid cysts are germ cell tumour of the ovary which accounts for 20-25% of all ovarian tumour and are bilateral in 10-15% of cases. These tumour have a low ...incidence of malignancy, reported as 1-3%. The aim of the study is to determine the safety and efficacy of the laparoscopic management of ovarian dermoid cyst over laparotomy.
Methods: This prospective study was conducted in the Department of Obstetrics and Gynaecology, BIRDEM-II General Hospital, from January 2013-December 2018. During the study period, a total of sixty subjects were included for comparison. Thirty patients were selected for laparoscopic ovarian cystectomy and another thirty patients were selected for laparotomy. They were randomly selected for the procedures.
Result: Thirty patients with ovarian dermoid cyst undergoing laparospic surgery were compared with thirty patients with ovarian dermoid cyst undergoing laparotomy in respect to selection criteria, surgical procedures, operation time, blood loss, hospital stay and outcome of operation. Although the operation time for ovarian cystectomy performed by laparoscopic surgery was slightly longer (62.15 ± 16.3 min, mean ± SD) than by laparotomy (50 ± 16.20 min, p < 0.52), blood loss is smaller and hospital stay is shorter in laparoscopic group than laparotomy.
Conclusion: The laparoscopic approach is generally considered to be the gold standard for the management of dermoid cyst. We believe that laparoscopic management of dermoid cyst may be a safe and beneficial procedure when performed by experienced surgeon.
Bangladesh J Obstet Gynaecol, 2020; Vol. 35(2): 107-111
Sertoli-Leydig Cell Tumor (SLCT) is an extremely rare and distinctive sex cord-stromal tumor. Ovarian sex cord-stromal tumors are infrequent tumors that differ from the more frequent epithelial ...neoplasm and have strong association with hormone-mediated syndromes, presentation in a wide age range, and the diagnosis is usually at early-stage disease with a good outcome. SLCT typically present with pelvic or abdominal pain and tenderness, mass, and or abnormal menstruation, and with hormonal activity reported predominantly after menarche. We report a case of 18-year-old unmarried female presented with severe pain and lump in the lower abdomen. She was a case of primary amenorrhea with normal secondary sex characters. She was a suspected case of twisted ovarian tumor on USG and underwent laparotomy followed by total excision of the lump and histopathology report revealed Sertoli-Leydig Cell Tumor. Though it is a rare tumor, the possibility of Sertoli-Leydig Cell Tumor in a young woman should be kept in mind. Key Words: Ovarian tumor, Sclerosing stromal tumor, sex cord-stromal tumor, Sertoli- Leydig Cell Tumor.
Bangladesh J Obstet Gynaecol, 2017; Vol. 32(2) : 117-120
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