How Frequent Multi Follicular Response in Intra Uterine Insemination Cycle Leads to Multiple Pregnancy in Prolong Primary Subfertile Patient?

Previously published studies on multi follicular studies are not consistent. Intra uterine insemination (IUI) is a good treatment option for limited resource countries because of its cost effectiveness and easy accessibility in remote areas. We aimed to identify pregnancy determining factors of IUI following controlled ovarian stimulation among educated sub fertile women in Bangladesh. A cross sectional retrospective study was conducted at Fertility Center of Evercare Hospital Dhaka, Bangladesh from January 2016 to December 2018 where 518 IUI cycles performed after taking written consent from participants. A total of 426 couples medical records were analyzed on the basis of inclusion and exclusion criteria. ovarian stimulating agent like clomiphene citrate tablet and human menopausal gonadotropin (HMG) subcutaneous injection alone or combined has been given to every women under this study. While at least one follicle diameter reached 18 mm then intramuscular Human Chorionic Gonadotropin (HCG) was given and IUI procedure was performed after 36 hours later. While analyzing the data a higher mea n± SD was observed in pregnant groups than non-pregnant one regarding women’s age, BMI, their husband’s initial total motile sperm, inseminated harvested sperm and endometrial thickness though duration of married life was more in non-pregnant but these were not statistically significant. But the number of mature follicle was significantly higher in pregnant woman (P< 0.001). More than three follicle yield highest pregnancy than single or double follicles. Multi follicles showed a gradual decrease with age. A higher IUI was observed in woman with normal ovarian reserve. We propose that, IUI could be an effective therapeutic procedures for women with primary subfertility and could aid as an effective assisted reproductive technology in medical science

Association of gestational diabetes mellitus with vitamin D status among women attending at Bangabandhu Sheikh Mujib Medical University

Gestational diabetes mellitus (GDM) is an important cause of maternal and perinatal morbidities. Vitamin D is associated with glucose metabolism. The present study was aimed to assess the association of maternal serum vitamin D level with GDM. This case-control study was conducted among 80 pregnant women at the Department of Obstetrics and Gynecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Among the 80 patients, 40 were GDM patients (cases) and 40 pregnant women without GDM (controls). The serum vitamin D level was measured for all of them. The mean vitamin D level of the cases and controls were 18.8±5.5 ng/ ml and 22.1±7.3 ng/ml, respectively (P=0.025). There was significant difference regarding the vitamin D adequacy in between case and control groups (P= 0.006) and the respondents with vitamin D <30.0 ng/ml had 7.2 times more chances to have GDM compared to that of the respondents with vitamin D ≥30 ng/ml (OR=7.2; 95% confidence interval =1.5-35.1). There was a significant negative correlation between serum vitamin D level and plasma glucose level 2-hour after 75 gm glucose drink (r= -0.33, P= 0.004). In conclusion, serum vitamin D level was found low in patient with GDM compared to those without GDM. BSMMU J 2022; 15(3): 162-16

Scaling up early action: Lessons, challenges and future potential in Bangladesh

‘Forecast-based early action’ (FbA) is emerging among humanitarian and disaster risk management practitioners as an approach that can reduce the impact of shocks on vulnerable people and their livelihoods, improve the effectiveness of emergency preparedness, response and recovery efforts, and reduce the humanitarian burden. • This paper investigates the technical, economic and institutional challenges to scaling up FbA in Bangladesh. Taking a political economy approach it examines the structures and policies around disaster management in the country, options for financing, and the forecasting infrastructure and dissemination systems. • The concept of FbA is not new to Bangladesh but triggers for action are often unclear. The Cyclone Preparedness Programme has long used forecasts to trigger early warning, preparedness and evacuation. However, in most other cases triggers for action are determined more subjectively. • The risk of ‘acting in vain’ is a major perceived barrier to scaling up FbA. Taking early action when forecasts prove inaccurate has potential implications for accountability and perceived misallocation of limited resources. But if targeted at poor groups, actions could anyway help to enhance resilience. • Institutional incentives and finance are still skewed towards relief. Post-disaster response is seen as more visible and defensible, forming a barrier to early actions. Scaling up of FbA could help to reform prevailing cliental biases in relief by making targeting and delivery of aid more transparent, equitable and needs-based. • Value for money? Stakeholders are demanding for better evidence on the (cost)-effectiveness of FbA approaches. Pilots in Bangladesh suggest improved food security, reduced lending costs and lower anxiety/depression among those taking early action before disasters. • Forecasting is limited but has future potential. Tidal influence makes it difficult to forecast flooding in the southern and coastal zones, while the inaccuracy of cyclone forecasting leaves a limited window for early actions. Riverbank erosion and flash flood forecasts have future potential, along with efforts to improve impact-based forecasting

The association of maternal serum CRP level with gestational diabetes mellitus

Gestational diabetes mellitus is a common medical condition during pregnancy that has detrimental effects on maternal health and fetal well-being. Many serum markers are known to be associated with gestational diabetes, a subclinical inflammatory state that liberates inflammatory mediators, acute phase proteins like CRP into the maternal circulation. This phenomenon has invited many researchers to study inflammatory mediators and acute phase proteins as markers of gestational diabetes mellitus.This case-control study was conducted in the Department of Obstetrics and Gynecology of Bangabandhu Sheikh Mujib Medical Univer- sity, Dhaka, between July 2016 and June 2017. The objective of the study was to evaluate the association of serum CRP level with gestational diabetes mellitus. A total of 140 pregnant women who attended the out-patients antenatal clinic at their 2nd and 3rd trimester (13-40 weeks) of pregnancy were enlisted for the study. The case group consisted of 70 pregnant women who were diagnosed with GDM. Similar number of healthy pregnant women were recruited as control. GDM was diagnosed using standard 75 g OGTT. Blood sample was taken from study subjects to estimate the serum CRP level. CRP level up to 5mg/L was taken as normal. Data analysis was done by utilizing SPSS version 16. The mean BMI of the case group women was significantly higher than the mean BMI of the control (p=0.001). The mean CRP level in case was 13.87±10.19 and the mean for CRP for control group was 4.59±2.41. There was an association of raised level of CRP with GDM. Pregnant mothers with raised level of CRP (& gt; 5 mg/L) were 6.1 times more likely to have GDM than mothers with normal level of CRP. The study concluded that a significant association was found between the raised level of CRP and gestational diabetes mellitus. BSMMU J 2022; 15(2): 96-10

Monitoring antimicrobial susceptibility of Neisseria gonorrhoeae isolated from Bangladesh during 1997- 2006: Emergence and pattern of drug-resistant isolates

Gonorrhoea is one of the most common sexually transmitted infections (STIs) in developing countries, and the emergence of resistance to antimicrobial agents in Neisseria gonorrhoeae is a major obstacle in the control of gonorrhoea. Periodical monitoring of antimicrobial susceptibility of N. gonorrhoeae is essential for the early detection of emergence of drug resistance. In total, 1, 767 gonococcal strains isolated from males and females (general population and those with high-risk behaviour) from different parts of Bangla-desh were studied during 1997- 2006 . Minimum inhibitory concentrations of penicillin, tetracycline, cipro-floxacin, ceftriaxone, spectinomycin, and azithromycin for the isolates were determined by the agar dilu-tion method. Isolates resistant to three or more antimicrobial agents are considered multidrug-resistant. The prevalence of plasmid-mediated penicillinase-producing N. gonorrhoeae (PPNG) and plasmid-mediated tetracycline-resistant N. gonorrhoeae (TRNG) was determined. Nine percent of the isolates were resistant to ciprofloxacin in 1997 compared to 87% in 2006. Multidrug-resistant N. gonorrhoeae have emerged in 1997 , and 44% of the strains (n= 66) isolated during 2006 were multidrug-resistant. Forty-two percent of the isolates in 2006 were both PPNG- and TRNG-positive compared to none in 1997 . The rapidly-changing pattern of gonococcal antimicrobial susceptibility warrants the need for an antimicrobial susceptibility-monitoring programme, and periodical analysis and dissemination of susceptibility data are essential to guide clinicians and for successful STI/HIV intervention programmes

Development of photo-affinity label peptides for mapping therapeutically-relevant protein-protein interactions

Our work involves in developing chemical tool with photoaffinity label to study therapeutically relevant PPI

Case Reports Spontaneous Hemoperitoneum from a Ruptured Superficial Uterine Vessel in Third Trimester of Pregnancy

Spontaneous hemoperitoneum in third trimester of pregnancy is a very rare but lethal condition which demands prompt diagnosis and management for the survival of both mother and fetus. A 30 years old multipara woman presented at 34 weeks of pregnancy with acute abdominal pain and hypovolemic shock. Emergency exploratory laparotomy was done; an asphyxiated baby was born by cesarean section. One of multiple engorged superficial vessels on posterior surface of the uterus was found bleeding actively, which was then sutured. Post operative recovery of the patient was good. Hemoperitoneum during pregnancy is rare but potentially life threatening to both mother and fetus. Spontaneous hemoperitoneum may develop from rupture of various abdominal or pelvic structure

Relationship between severity of hypertension and renal impairment in preeclampsia

The aim of this study was to determine the relationship between the severity of hypertension and renal impairment in preeclampsia. This study was conducted on 92 diagnosed cases of mild (n=42) and severe (n=50) preeclampsia patients from August 2010 to July 2011. All the patients were almost identical in terms of age and socioeconomic status. The results of the study showed that the mean serum creatinine and uric acid levels were significantly high in severe preeclampsia patient compared to mild preeclampsia and both systolic and diastolic blood pressures had the positive and significant effects on the serum creatinine and uric acid levels. In conclusion, impairment of renal function has the positive and significant relationship with the severity of blood pressure in the preeclamptic patient

REVIEW ARTICLES ENVIRONMENTAL AND NUTRITIONAL ASPECT IN

Male and female partner of a couple must be standard and fit to have the capacity to procreate. Studies confirm that male sperm counts are declining and environmental factors as pesticides, exogenous estrogen, heavy metals negatively impact spermatogenesis without any obvious anatomical defects. So, a number of nutritional therapies have been shown to improve sperm count and motility as carnitine, arginine, zinc, selenium and vitamin B. Numerous anitioxidants 12 have prove beneficial in treating male infertility as Vitamin C, Vitamin E, Glutathione and Coenzyme Q10. This article aims to highlight the correction of nutritional imbalances to encourage optimum sperm production and function, when there is idiopathic impaired spermatogenesis. An estimated six percent of adult males are found infertile. 1 Infertility is defined as the inability to achieve a pregnancy after one year of unprotected coitus 2