The quest for better outcomes: a randomized controlled trial comparing letrozole versus clomiphene citrate in polycystic ovarian syndrome related infertility

Background: Infertility is a widespread concern, particularly among individuals with polycystic ovarian syndrome (PCOS). Clomiphene citrate (CC) has been a primary treatment for PCOS-related infertility, despite suboptimal pregnancy rates. Letrozole, an aromatase inhibitor, presents an alternative with potential advantages for improving pregnancy outcomes. This study aimed to rigorously compare letrozole and CC in the context of PCOS-related infertility, focusing on Bangladeshi women, adopting incremental dosing protocols, and examining endpoints to contribute valuable insights. Methods: A randomized controlled trial was conducted at a tertiary care center in Bangladesh from July 2021 to June 2023. Participants included women aged 18-35 with anovulatory infertility due to PCOS. They were randomized into two groups: letrozole and CC. Treatments were administered following incremental dosing protocols, and outcomes included endometrial thickness, ovulation rate, mono-follicular development, pregnancy rate, and time to pregnancy. Results: Out of 187 patients assessed for eligibility, 102 were enrolled, with 51 in each group. Demographics were comparable between groups. While endometrial thickness did not significantly differ between the groups, letrozole demonstrated a higher rate of mono-follicular development (72.55% versus 50.98%), a significantly higher pregnancy rate (47.06% versus 23.53%), and a shorter time to pregnancy (9.23 weeks versus 11.7 weeks) compared to CC. Conclusions: This study suggests that letrozole may be a preferred option for ovulation induction in PCOS patients due to its superior pregnancy rates and shorter time to pregnancy compared to CC. However, limitations such as a relatively small sample size and variations in dosages should be considered. Further research is needed to validate these findings and address the evolving needs of patients with PCOS-related infertility

Screening for cervical cancer (By VIA Test) among selected garments worker in Chattogram, Bangladesh

Background: Bangladesh is a densely populated country of South East Asia with low resource setting where cervical cancer is the 2nd leading cause of female cancer. In more than 80% cases are diagnosed at advanced and inoperable stage. Regarding socio demographic context of this country VIA has been introduced as a screening method for cervical cancer which is most simple, cost effective, and acceptable test for all women. In Bangladesh among 3 million garment workers more than 80% are women. The objective of this study was to identify prevalence of VIA positive cases among garment workers. So that it can reduce the incidence of cervical cancer in Bangladesh. Methods: It was a cross–sectional observational study conducted in some selected garment factories in Chattogram city of Bangladesh from January 2021 to July 2021, where we enrolled 534 female workers for VIA test. Results: Among all the respondents 56% were 30 years or younger, 38% were aged between 31 to 40 years. Among 534 participants, 44.9% completed primary education, 37.3% were smoker and 34.5% had their children at early age. Majority (86.7%) had excessive whitish discharge. Post coital bleeding and irregular bleeding was 2.6% and 2.2% respectively. Considering awareness, 61.8% had idea about cervical cancer, only 1.1% had undergone VIA test in the past. In our study we found 2.4% of participants were VIA positive cases. Conclusions: It is important to include the garment workers, while making public health policies and implementation of cervical cancer control program

Reaching an Agreement for the Elimination of Child Labour from the Supply Chains

This article examines how child labour can be eliminated from various supply chains in Bangladesh. Reinforcing this issue is important to comply with international labour standards on child labour and to avoid potential trade sanctions of various types. Drawing upon the examples of other mechanisms to implement international labour standards particularly in a situation when domestic initiatives remain largely ineffective, it is argued that various local and international actors in the supply chains have a key role to play in actively enforcing this international standard to help support an economy free from the curse of child labour. This article proposes that an international legally binding agreement among global importers, unions, and local stakeholders to improve the child labour situation may provide the best mechanism to eliminate this problem from various supply chains in Bangladesh

Urban design and social capital: lessons from a case study in Braunstone, Leicester

A valuable asset in sustainable regeneration is the ‘community’ with their developed networks, bonds and ties or in other words its social capital which is a useful resource. Braunstone in Leicester is typical of many disadvantaged areas in the UK, with persistent socio-economic problems exacerbated by a poor physical setting. With a large regeneration programme funded by the New Deal for Communities coming to a close, we conducted a case study to explore the impact of improved local facilities and the effect of walkability on social capital. The lessons learnt suggests that responding to needs at a finer grain is vital in developing neighbourhoods for social capital such as responding to the needs of different user groups, responding to local patterns of use and needs of micro localities, and improving the perceptions of neighbourhoods. Local facilities and neighbourhood walkablity provides incentives for longer term residency, and facilitates interaction which helps social capital to grow. Accessing services by walking and using public transport proves vital to engage in social activities, while a poor physical environment, lack of accessible services and public transport negatively affects participation in social and leisure activities. Facilities and buildings provide a mediating role in developing social capital in a community, providing opportunity for social interaction which encourages people to reside in an area for longer. Improving connections beyond the neighbourhood is important to help retain people for longer term residency to develop social capital

Salmonella Typhi and Plasmodium falciparum Co-infection in a 12-year Old Girl with Haemoglobin E Trait from a Non-malarious Area in Bangladesh

A 12-year old girl from Uttar Badda, Dhaka, Bangladesh, was admitted to the Dhaka Hospital of ICDDR,B, with a 23-day history of fever and diarrhoea. After admission, she was treated for culture-proven Salmonella Typhi-associated infection and was discovered to be heterozygous for haemoglobin E. Despite treatment with appropriate antibiotics, the patient's condition did not improve, prompting further investigation, which revealed malaria due to Plasmodium falciparum. Dhaka is considered a malaria-free zone, and the patient denied recent travel outside Dhaka. Subsequently, the patient recovered fully on antimalarial therapy

Husbands' involvement in delivery care utilization in rural Bangladesh: A qualitative study

Abstract Background A primary cause of high maternal mortality in Bangladesh is lack of access to professional delivery care. Examining the role of the family, particularly the husband, during pregnancy and childbirth is important to understanding women's access to and utilization of professional maternal health services that can prevent maternal mortality. This qualitative study examines husbands' involvement during childbirth and professional delivery care utilization in a rural sub-district of Netrokona district, Bangladesh. Methods Using purposive sampling, ten households utilizing a skilled attendant during the birth of the youngest child were selected and matched with ten households utilizing an untrained traditional birth attendant, or dhatri. Households were selected based on a set of inclusion criteria, such as approximate household income, ethnicity, and distance to the nearest hospital. Twenty semi-structured interviews were conducted in Bangla with husbands in these households in June 2010. Interviews were transcribed, translated into English, and analyzed using NVivo 9.0. Results By purposefully selecting households that differed on the type of provider utilized during delivery, common themes--high costs, poor transportation, and long distances to health facilities--were eliminated as sufficient barriers to the utilization of professional delivery care. Divergent themes, namely husbands' social support and perceived social norms, were identified as underlying factors associated with delivery care utilization. We found that husbands whose wives utilized professional delivery care provided emotional, instrumental and informational support to their wives during delivery and believed that medical intervention was necessary. By contrast, husbands whose wives utilized an untrained dhatri at home were uninvolved during delivery and believed childbirth should take place at home according to local traditions. Conclusions This study provides novel evidence about male involvement during childbirth in rural Bangladesh. These findings have important implications for program planners, who should pursue culturally sensitive ways to involve husbands in maternal health interventions and assess the effectiveness of education strategies targeted at husbands.http://deepblue.lib.umich.edu/bitstream/2027.42/112942/1/12884_2011_Article_487.pd

STUDIES ON TENSILE PROPERTIES AT VARIOUS STRAIN RATES AND CORROSION BEHAVIOR OF PEAKAGED AL-6SI-0.5MG (-0.5CU) ALLOYS

This paper focuses the effect of Cu additions on tensile properties of Al-6Si-0.5Mg alloy at various strain rates and electrochemical corrosion behavior. The additions of Cu resulted in an increase in tensile strength and showed higher strength all over the experimental strain rates. Evaluations of tensile properties at the three different strain rates (10-4, 10-3 & 10-2s-1) showed that they affected the tensile properties significantly. The strength was better at higher strain rate but ductility was poor. Eelectrochemical impedance spectroscopy (EIS) and potentiodynamic polarisation have been used to evaluate the corrosion resistance of Cu free and 0.5wt% Cu content Al-6Si-0.5Mg alloy in 0.1M NaCl solution. The 0.5wt% Cu addition to the Al-6Si-0.5Mg alloy showed that Cu decreased susceptibility to corrosion compared to the Cu free Al-6Si-0.5Mg alloy. The magnitude of open circuit potential (OCP), corrosion potential (Ecorr) and pitting corrosion potential (Epit) of Al-6Si-0.5Mg alloy were shifted to the more noble direction due to 0.5wt% Cu addition and thermal modification

Effects of Phytobiotic of Curcuma aeruginosa, Curcuma longa and Zingiber officinale on the Performance and Carsass Quality in Broiler: Pengaruh Fitobiotik Temu Ireng (Curcuma aeruginosa), Kunyir (Curcuma longa) Dan Jahe Merah (Zingiber officinale) Terhadap Performa Dan Kualitas Karkas Ayam Pedaging

The purpose of this study was to investigate the effects of the use natural antibiotics (phytobiotic) Curcuma aeruginosa, Curcuma longa and Zingiber officinale as an alternative antibiotic on the performance of broiler. Experimental design was a Completely Randomized Design using 440 broiler of one day-old chicks and randomly divided into 11 treatments with 4 chickens for each treatmen. The dietry treatments were negative control (T01), a basal diet without any feed additives and positive control (T02), a basal diet with bacitracin, and basal diets with additional different levels (0.75, 1.0, and 1,5%) of Curcuma aeruginosa (TI1, TI2, and TI3), Curcuma longa (KU1, KU2, and KU3) and red ginger (JM1, JM2, and JM3), respectivelly. The results showed that the addition of low-dose phytobiotic (0.75%) in broiler have produced a different effect (P <.05) on the parameters of performance, but at higher doses, the results tend to show the opposite effect. However, low-dose treatment phytobiotic parameters showed no differences (P>.05) with positive control treatment of bacitracin. In conclusion, the use of phyitobiotics Curcuma aeruginosa, Curcuma longa and red ginger has showed their function as growth promoters in low dose