Effect of autologous platelet rich plasma on anti-mullerian hormone and antral follicle count in sub fertile women with poor ovarian reserve

Background: Ovarian aging may be reversible. Platelet rich plasma (PRP) has growth factors that promote cellular proliferation and folliculogenesis. Recently published studies and case reports suggest that ovarian rejuvenation can be done by PRP treatment. The objective of the study was to evaluate the effect of platelet rich plasma on ovarian reserve markers such as anti mullerian hormone (AMH) and antral follicle count (AFC) in sub fertile women with poor ovarian reserve (POR).Methods: The self-controlled quasi experimental study was carried out on 29 sub fertile women with poor ovarian reserve. They were selected for laparoscopic tubo-peritoneal evaluation as they could not afford in vitro fertilization. During laparoscopy, 5 ml of pre prepared autologous PRP was injected into each ovary. Post-PRP AMH and AFC were measured at every cycle for a period of at least three (3) months and compared with base line values.Results: Mean age of participants was 35.9±3.2 years. Baseline AMH was 0.31±0.17 ng/ml and baseline AFC was 3.41±0.73. AMH was raised on first, second and third cycle from base line values in 58.62%, 86.21% and 91.30% of the study population respectively. AMH changes in all three cycle were statistically significant. Pregnancy occurred in three (10.34%) women during the study period.Conclusions: The injection of autologous PRP into human ovaries is a safe procedure to improve ovarian reserve markers (AMH and AFC) in women with POR

Efficacy of autologous platelet rich plasma for ovarian rejuvenation in infertile women having poor ovarian reserve

Background: Poor ovarian reserve (POR) is a condition in which the ovary loses its normal reproductive potential and compromising fertility. Normal function of the ovaries and adequate good quality follicles are responsible for the reproductive process of a woman. Various treatment methods exist for POR, but the present study was conducted to observe the effectiveness of platelet rich plasma infusion through measurement of AMH and AFC values and pregnancy outcomes.Methods: This prospective observational study was done in the department of reproductive endocrinology and infertility from July 2019 to June 2022. A total of 60 patients with poor ovarian reserve were recruited maintaining inclusion and exclusion criteria.Results: Mean age of the participants was 36.4 years, with 78.32% of the participants being housewives and 21.68% being service workers. 65.38% had education below SSC levels. 72.46% had primary infertility while 27.54% had secondary infertility. At first cycle, compared to baseline counts, mean±SD AMH had increased by 0.04±0.15 ng/dl, and mean±SD AFC had increased by 1.34±1.89 in number. During second cycle post-PRP, the mean difference of AMH and AFC was 0.18±0.21 ng/dl and 2.17±1.71 in a positive manner. By final follow-up, pregnancy rate was 20% among patients.Conclusions: The study observed significant improvement in AMH and AFC values following PRP infusion. The improvement of both values was gradual, and increase of AMH values were observed up to second post-PRP menstrual cycle, while AFC increased till third cycle post-PRP. Among 60 patient twelve (12) had pregnancy (20%)

Diagnosed hematological malignancies in Bangladesh - a retrospective analysis of over 5000 cases from 10 specialized hospitals

Background The global burden from cancer is rising, especially as low-income countries like Bangladesh observe rapid aging. So far, there are no comprehensive descriptions reporting diagnosed cancer group that include hematological malignancies in Bangladesh. Methods This was a multi-center hospital-based retrospective descriptive study of over 5000 confirmed hematological cancer cases in between January 2008 to December 2012. Morphological typing was carried out using the “French American British” classification system. Results A total of 5013 patients aged between 2 to 90 years had been diagnosed with malignant hematological disorders. A 69.2% were males (n = 3468) and 30.8% females (n = 1545), with a male to female ratio of 2.2:1. The overall median age at diagnosis was 42 years. Acute myeloid leukemia was most frequent (28.3%) with a median age of 35 years, followed by chronic myeloid leukemia with 18.2% (median age 40 years), non-Hodgkin lymphoma (16.9%; median age 48 years), acute lymphoblastic leukemia (14.1%; median age 27 years), multiple myeloma (10.5%; median age 55 years), myelodysplastic syndromes (4.5%; median age 57 years) and Hodgkin’s lymphoma (3.9%; median age 36 years). The least common was chronic lymphocytic leukemia (3.7%; median age 60 years). Below the age of 20 years, acute lymphoblastic leukemia was predominant (37.3%), followed by acute myeloid leukemia (34%). Chronic lymphocytic leukemia and multiple myeloma had mostly occurred among older patients, aged 50-over. Conclusions For the first time, our study presents the pattern and distribution of diagnosed hematological cancers in Bangladesh. It shows differences in population distributions as compared to other settings with possibly a lower presence of non-Hodgkin lymphoma. There might be under-reporting of affected women. Further studies are necessary on the epidemiology, genetics and potential environmental risk factors within this rapidly aging country

Live bird market in Bangladesh: regulatory systems and operations

Objective: In developing countries, such as Bangladesh, the live bird market (LBM) is a vital location for the trading of live poultry. The study was carried out in nine LBMs located around Bangladesh to ascertain the present regulations and procedures governing their operation. Additionally, the responsibilities and levels of engagement of the stakeholders were determined. Materials and Methods: The data were gathered through the use of a semi-structured interview guide. Thematic analysis was used to code the interview transcripts iteratively. Results: The findings indicated that the government was directly and indirectly involved in the leasing process of the markets. A market in this country is divided into numerous sectors, includ- ing LBM, fish market, vegetable market, and grocery stores. A market's hygienic condition is highly dependent on market authority's decisions. In some markets, market officials conducted routine sanitary inspections. Veterinarians played a little role in the inspection procedure. Conclusion: There is no adequate, functional monitoring system to ensure that LBMs adhere to cleanliness and adequate and functional biosecurity. Biosecurity enhancements, effective clean- ing programs, and regular monitoring by relevant authorities are critical for LBMs in Bangladesh

Reducing behavioural and psychological symptoms of dementia in older adult long term care home residents with virtual reality therapy

Individuals with dementia often exhibit Behavioural and Psychological Symptoms of Dementia (BPSD). BPSD worsens as dementia progresses and intensifies caregiver distress. The Registered Nurses’ Association of Ontario recommends non-pharmacologic methods such as group activities, music therapy, cognitive behavioral therapy, and cognitive stimulation therapy (CST) to manage BPSD. I wanted to explore the potential of virtual reality (VR) as a possible CST for Ontario long-term care home (LTC) residents with moderate to severe dementia. I analyzed data of a single site case series (n=24), piloted to explore the feasibility of VR therapy, residents’ tolerance for the therapy, facilitators and barriers to implementing the therapy, sensitivity to change, and longitudinal construct validity of the selected BPSD measuring tools. The VR therapy was provided with Broomx© (http://www.broomx.com/broomxvr.php) for 30 minutes, five days a week for two weeks. The analysis revealed that older adults with moderate to severe dementia could tolerate VR therapy. Strategies such as use of Broomx© projector instead of headset, tailored VR library items, and a soundproof room with no visual distractions facilitated, whereas residents’ conflicting schedule challenged, VR implementation. The selected measuring tools were sensitive to change and were valid. The logistics of collecting these measures were of concern since they were additional to mandated outcomes and had to be completed by Personal Support Workers. I also performed an interpretive description using semi-structured interviews (n=15) with individuals positioned to observe the residents during the pilot. In my interpretation, residents’ mood, demeanor, and daily activities improved noticeably during VR therapy. Several issues (e.g. VR library items, therapy schedule, staff commitment) were important in implementing the therapy. Based on the findings from both studies, I designed a matched-pair cluster randomized control trial (CRT) using mandated outcome measures in 659 participants or 28 LTC homes or 14 matched-pairs to evaluate if usual care and VR therapy can reduce BPSD in older adults with moderate to severe dementia living in Ontario LTC compared to usual care alone, useful in clinical decision making. The CRT also will compare the cost between the intervention and control