Politics of Controlling Birth: C-Section, Use of Contraception and Obstetrics Violence in Bangladesh

This study examines the increasing rate of cesarean birth in Bangladesh through the lens of the population control program. Based on three months of data collection, the study explores various politics of the government’s population control program, leading me to argue that cesarean birth is an implicit way of controlling overpopulation in Bangladesh since it limits women’s reproductive choices and thus contributes to population control. Using ethnographic vignettes, I discuss how my research findings point to the government’s disparate population control politics and how this has given rise to various forms of obstetric violence against women. The study also addresses cesarean birth and obstetric violence as forms of “reproductive governance”—mechanisms to control women’s reproduction. This thesis concludes by recommending further studies on the connection between cesarean birth and population control from a cross-cultural perspective

Toxicity outcome of concurrent teletherapy and brachytherapy compared with teletherapy followed by brachytherapy in locally advanced carcinoma cervix

Background: Teletherapy and intracavitary brachytherapy are definitive treatment modalities for stages IIB to IVA cervical carcinoma. Globally, it is the second most common cancer among female. Majority of patients attend the hospital with locally advanced stage due to less screening facility and social stigma.Methods: This quasi-experimental study was conducted from January 2019 to June 2020 with a total of 76 patients. The patients were equally divided into two groups: A and B after obtaining their informed written consent.Results: Final follow up was given after completion of treatment at 24 weeks. Patients in both groups developed grade 1 gastrointestinal and genitourinary toxicities (10.5% versus 13.1%, 13.1% versus 15.7% in group A and B respectively). Two patients in group A and three patients in group B developed grade 2 gastrointestinal toxicities. In genitourinary toxicities, grade 2 toxicities were observed in two patients of group A and four patients of group B, (p>0.05). None developed grade 3 and 4 gastrointestinal and genitourinary toxicities. There were no statistically significant variations in treatment related toxicities between the two groups.Conclusions: Both gastrointestinal, genitourinary toxicities were comparable between two groups. The toxicities were acceptable and well tolerated.

Comparison of dosimetric parameters between intensity modulated and three-dimensional conformal radiotherapy planning for adjuvant therapy of gastric cancer

Background: Adjuvant chemoradiotherapy is the standard treatment for gastric carcinoma, but the optimal radiation modality remains uncertain. This study aimed to compare intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3D-CRT) in terms of dosimetry for adjuvant gastric cancer treatment. Methods: 21 patients with stage IIB-IIIC gastric cancer, treated between January and June 2021, underwent surgery followed by adjuvant chemoradiation with both IMRT and 3D-CRT plans. Dosimetric parameters were calculated for the planned target volume (PTV) and organs at risk (OAR). Results: Both IMRT and 3D-CRT provided comparable PTV coverage. However, IMRT significantly improved kidney sparing, reducing the mean V20 value by 23% (p=0.01) for the right kidney and 26% (p=0.02) for the left kidney compared to 3D-CRT. IMRT also decreased the mean irradiated volume for both kidneys and the liver, as well as the V30 value for the liver, although these differences were not statistically significant. The dosimetric parameters for the spinal cord were comparable between IMRT and 3D-CRT plans. Conclusions: IMRT demonstrated better kidney sparing compared to 3D-CRT in adjuvant radiotherapy for gastric cancer, while PTV coverage was similar. Long-term follow-up is necessary to assess clinical outcomes and local recurrence rates for both treatment plans

Immunofluorescence pattern of antinuclear antibody and its association with autoantibody profile in systemic lupus erythematosus

Background: Antinuclear antibody (ANA) is useful in the diagnosis of systemic lupus erythematosus (SLE). Association of specific autoantibodies with the immunofluorescence pattern of ANA in SLE as noted in Western literature has been taken as reference in all over the world. However, in Bangladesh such research work or data correlating the autoantibodies and their ANA patterns is inadequate. Objective: To identify an association between immunofluorescence patterns of antinuclear antibody on HEp-2 cell and more specific antinuclear reactivities (e.g. anti-dsDNA and anti-extractable nuclear antigen) in the serum samples of SLE patients.Methods: Serum samples of 37 SLE patients who were diagnosed by ARA (American Rheumatism Association) classification criteria and laboratory tests, attending at lupus clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU) during the study period of six months were subjected for ANA testing by Indirect Imrnunofluorescence (IIF) on HEp-2 cell, anti-dsDNA by ELISA and anti- extractable nuclear antigen (anti-ENA) by Dot Immunoblot. Dot blot strips were tested for anti-Sm, anti-RNP, anti-SSA/Ro, and anti-SSB/La. Results: Out of 37 SLE patients 32 (86.5%) cases were ANA positive by IIF on HEp-2 cell. ANA positive sera exhibited three fluorescence patterns such as speckled (43.7%), peripheral (34.3%) and homogenous pattern (21.8%). Peripheral pattern (100%) was strongly associated with anti-dsDNA (p<0.05) and homogenous pattern (85.7%) was also predominantly associated with anti-dsDNA (p<0.05). Speckled pattern (85.6%) was significantly associated with anti-ENA (p<0.05). Anti-dsDNA was positive in 75% of SLE cases and majority (45.8%) of which showed peripheral pattern whereas anti-ENA was positive in 48.6% cases and majority (70.5%) of which showed speckled pattern. The most commonly identified antinuclear autoreactivity was directed towards anti-RNP (22.2%) then anti-Sm (16.6%), anti-SSA (16.6%) and anti-SSB (11.1 %). Multiple anti-ENA reactivities were identified in 33.3% cases. Conclusion: Peripheral and homogenous pattern is strongly associated with anti-dsDNA therefore may be predicted that patients have active SLE and speckled pattern may predict anti-ENA (specially ribonucleoprotiens). Thus, ANA-IIF method may suffice and probably reduce the expense of detailed immunological work-up with minimal loss in diagnostic accuracy

Clinicopathological pattern and risk factors of carcinoma breast in younger age group

Worldwide, breast cancer is the most frequently diagnosed life-threatening cancer and the leading cause of cancer death among women. Approximately 7% of all breast cancers are diagnosed in women <40 years of age. Young age at diagnosis influences prognosis negatively as they present with more advanced disease at diagnosis and a poorer 5-year survival than older patients. The present study includes breast cancer patients in the age group of 18 to 40 years to enrich our knowledge about clinical presentation and pathological characteristics of breast cancer. To find out the clinical presentation and pathological characteristics of breast cancer among the young age group.  This cross-sectional study was done over 100 cases of histopathologically proven breast cancer from structured Questionnaire was used as data collection tool. Mean age was 33.89 years. Among the respondents 88% are married. Among the total studied population 61 respondents had the history of oral contraceptive pill use. Family history of cancer presents in 13.0% respondents and absent in 87.0% respondents. Among the respondents 95% patients presented with lump in the breast. 97.0% had invasive carcinoma 90% were invasive ductal carcinoma in which 46.0% were moderately differentiated. 51.0% patients were in the stage IIa and stage IIb

Student Moderators in Asynchronous Online Discussion:Scaffolding Their Questions

Asynchronous computer-mediated conferencing (CMC) courses rely on sustained threaded discourse to encourage student learning. One successful approach for engaging students is through the use of peer moderators, whose goals are to focus and sustain the discussion, challenge students, and synthesize and summarize shared accomplishments. Peer moderators typically begin by posing thought-provoking questions to their peers, and it is known that different types of questions are differentially effective for generating higher-order discussion. However, prior literature suggests that students use very few question types, and tend to use types that have been linked to low levels of learning. In this research, we scaffold the questioning process, and then investigate the use and impacts of question type on resultant higher-order thinking. We find that the scaffolding led to a rich variety of question types, and that the evidence suggests new research directions for both Application and Course Link questions

Simple linear regression approach for evaluating models to estimate stature based on upper limb dimensions of adult Bangladeshi males

Background: The stature of a living human reflects the nutritional, genetic, and disease patterns of individual experiences. This study adopted a simple linear regression method and R2 values to identify the preferred model for stature estimation based on the lengths of the arm, radius, ulna, and hand; breadth of the hand; and circumference of the wrist of the adult Bangladeshi male population. This cross-sectional study was performed in the Anatomy Department of Sir Salimullah Medical College, Dhaka, from January 2009 to June 2011. One hundred right-handed adult Muslim Bangladeshi males aged 25 to 45 years participated in the study. Results: The regression model using right and left ulnar length explained 63% of the measured stature with the least standard error of the estimate (0.435 and 0.436), the model using left and right arm length explained 60%, the model using left and right radius length explained 51%, and the model using left- and right-hand length explained 44% of the measured stature. However, the models using left and right handbreadth and wrist circumference explained only 11 to 13% of the measured stature with a higher standard error of the estimate (6.66 to 6.73). For 25- to 45-year-old Bangladeshi Muslim males, the ulnar length of both sides was the best predictor of stature. Conclusions: Linear regression equations in estimating stature effectively may encourage its application in future studies addressing different age groups, sexes, nutritional statuses, religions, and ethnicities of Bangladesh

Clinicopathological pattern and risk factors of carcinoma breast in younger age group

Worldwide, breast cancer is the most frequently diagnosed life-threatening cancer and the leading cause of cancer death among women. Approximately 7% of all breast cancers are diagnosed in women <40 years of age. Young age at diagnosis influences prognosis negatively as they present with more advanced disease at diagnosis and a poorer 5-year survival than older patients. The present study includes breast cancer patients in the age group of 18 to 40 years to enrich our knowledge about clinical presentation and pathological characteristics of breast cancer. To find out the clinical presentation and pathological characteristics of breast cancer among the young age group.  This cross-sectional study was done over 100 cases of histopathologically proven breast cancer from structured Questionnaire was used as data collection tool. Mean age was 33.89 years. Among the respondents 88% are married. Among the total studied population 61 respondents had the history of oral contraceptive pill use. Family history of cancer presents in 13.0% respondents and absent in 87.0% respondents. Among the respondents 95% patients presented with lump in the breast. 97.0% had invasive carcinoma 90% were invasive ductal carcinoma in which 46.0% were moderately differentiated. 51.0% patients were in the stage IIa and stage IIb

Association of clinico-epidemiological features with locally advanced stage of cervical cancer patients presenting at Bangabandhu Sheikh Mujib Medical University, Bangladesh

Cervical cancer is one of the most prevalent gynecological cancers in women in Bangladesh. The objective of this study was to assess the clincoepidemiological association with the histology of locally advanced cervical cancer. We have done this observational study in the department of Clinical Oncology at Bangabandhu Sheikh Mujib Medical University from July to December 2019. Sixty-six biopsy-proven locally advanced (stage IIB to IVA) squamous cell carcinoma of uterine cervix were included in this study. The mean age of patients at diagnosis was 48.5 (±8.6) years. Commonly observed epidemiological characteristics of locally advanced carcinoma cervix were illiteracy (46.9%), oral contraceptive use (62.1%), multi para (78.7%) and early marriage (74.2%). Most frequent clinical presentation was post-coital bleeding (37.87%). Most patients presented in stage IIB (65.1%). The association of the stages of the disease with age, parity, oral contraceptive use, age at marriage and clinical presentation were statistically nonsignificant, whereas illiteracy was statistically significant. Most women had poor awareness regarding their need for routine check-up and screening as indicated by the late medical care seeking. Social stigma might have played some role. Relevant programmes should create awareness among women, especially those with socioeconomic deprivation. BSMMU J 2022; 15(3): 175-17

and Lung Infections in Bangladeshi Patients

Abstract Nocardiosis is an acute or chronic infectious disease that may occur in cutaneous, pulmonary and disseminated form in both immunocompromised and immunocompetent host. It may become potentially severe due to delayed diagnosis and incomplete or ineffective treatment. So the aim of the study was to isolate Nocardia spp. from suspected samples, mainly from chronic unhealed wounds and to identify appropriate antimicrobials by susceptibility testing in Bangladeshi patients. Methods: From January 2015-2017, 62 samples were collected which were studied for Nocardial identification and susceptibility testing. Results: Out of total 62 cases, 18 (29.03%) cases were Nocardia positive cases. Besides 6 Acinetobacter spp. and 2 Actinomyces spp. with other varied pathogens were isolated. Among 18 identified nocardiosis patients, majority (10) were post surgery cases, 6 suspected skin and glandular tuberculosis (TB) cases, one had breast sinus, and one was suspected pulmonary TB case. In terms of susceptibility of nocardial isolates, 100% were susceptible to linezolid, 88.9% to amikacin and 78% to trimethoprimsulphamethoxazole